Coordinates and facilitates administrative processes and services for the Department necessary to deliver and support care for patients. Supports the prior authorization process, scheduling, billing, and ordering of program supplies. May train on more complex prior authorization processes, support more complex patients with specialized treatments in support of patients with chronic diseases or conditions. Coordinates communications and services with insurance companies as directed. May assist with coordinating services with medical device and supply companies in support of providers' care.
This Patient Administrative Coordinator will be responsible for:
Manages the prior authorization process for patients and/or may train on more complex prior authorization processes in support of specialized medical devices
Prepares letters of medical necessity based on physician's notes
Serve as point of contact on the process for obtaining and responding to additional requests for prior authorizations for medicines/medical devices across relevant insurance companies for supported clinical area
Accurately creates and compiles bills and invoices (private insurance, Masshealth, and self-pay) with correct billing CPT code, diagnoses code, provider, etc. and submit to billing department as needed
As needed, prepares letters of medical necessity based on physician notes
Answers phone and email inquiries from patients and families and external companies in coordination of clinical services. Records and forwards messages as needed
Schedules new and return visits as needed. Verifies patient demographics. Collects all necessary clinical documentation and information
Responds to patient's concerns and needs within scope of knowledge and authority and in accordance with our best practices and procedures
Responds to situations requiring escalated service response, ensuring the appropriate providers and parties across multiple specialty areas are made aware of concerns and follows up to ensure resolution
Maintains tracking system of all orders
Orders and maintains supplies of designated medical devices
Reconciles statements from vendors with shipped orders
Confirms for specific patients and verifies that devices or equipment is available for return visits as needed
Actively participates in and contributes to departmental and organizational initiatives and projects with a focus on continuous process improvement
Recommends and assists in implementing change in internal systems and procedures
To qualify, you must have:
High school diploma. Some college or occupationally-specific education/training preferred.
Minimum of 1 year of experience in a high volume administrative role with an emphasis on problem resolution among multiple internal and/or external parties.
Ability to learn the prior authorization process for medicines.
Sufficient to strong organizational skills and attention to detail.
Ability to Persevere and follow through.
Initiative and inquisitiveness.
A sense of urgency and an ability to understand priorities and changes in priorities.
Proactive communication skills.
Boston Children's Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.
Boston Children's Hospital is a 395-bed comprehensive center for pediatric health care. As one of the largest pediatric medical centers in the United States, Children's offers a complete range of health care services for children from birth through 21 years of age.