At Boston Children's Hospital, success is measured in patients treated, parents comforted and teams taught. It's in discoveries made, processes perfected, and technology advanced. In major medical breakthroughs and small acts of kindness. And in colleagues who have your back and patients who have your heart. As a teaching hospital of Harvard Medical School, our reach is global and our impact is profound. Join our acclaimed Gastroenterology team and discover how your talents can change lives. Yours included.

The Patient Administrative Coordinator will be responsible for:

• Authorizations:
  • Manages the authorization process for a significant variety of medicines, specialized treatments, medical procedures, etc. for patients across multiple providers and specialties. Prepares letters of medical necessity based on physician notes
  • Under supervision, coordinates with insurance companies, specialty pharmacies and patient families for delivery of specialized treatments during clinic visits
  • Coordinates appeals with clinicians and patient families by preparing letters of appeal or connecting the clinician directly with the insurance company
  • Serves as a point of contract and subject matter expert on the process for obtaining and responding to additional requests for prior authorizations across supported clinical area
• Patient Encounters:
  • Answers, screens and routes a high volume of phone and email inquiries from patients, families and external companies in coordination of services. Records and forwards messages and triages calls to clinical staff for urgent information or services. Initiates calls for emergency services as required
  • Schedules patient encounters and procedures to coordinate across providers in multiple specialties. Verifies patient demographics, insurance/payment and referral information
  • Collects and organizes medical records, information, materials and supplies required for admissions or encounters. Communicates with other departments to coordinate ancillary clinical/administrative services
• Training:
  • Participates in the development of training programs to update staff on department/hospital processes particularly as it relates to prior authorizations
  • Trains, orients and cross-trains clinic staff in department systems, processes and terminology
  • Serves as resource on clinic/service operations and procedures, payer and billing requirements
• Process Improvement:
  • 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

• High school diploma required. Some college or occupationally-specific education/training preferred
• Minimum of 2 years of experience in a high volume administrative role with an emphasis on problem resolution among multiple internal and/or external parties. At least 1 of the 2 years should be in a healthcare or health insurance setting working with the prior authorization process
• Strong organizational skills and attention to detail
• An ability to manage multiple tasks within time constraints, as well as the ability to solve problems but with a keen sense of when to escalate for appropriate resolution