Patient Admin Coordinator (Physical Therapy)

Boston Children's Hospital; Boston (MA); On-site; USD 52,000 - 68,000; Full time

Benefits offered by this job

Flexible schedules

Health, vision and dental insurance

Tuition and certification reimbursemen

Retirement plan

Job summary

Boston Children\'s Hospital is seeking an organized administrative coordinator to support care delivery by handling patient inquiries, scheduling, and authorization processes. You will coordinate with multiple internal teams and insurers to ensure timely access to medications and procedures.

The role emphasizes learning and improving prior authorization workflows, maintaining accuracy in patient data, and working with diverse stakeholders across our care system.

Qualifications

• High School / GED required.
• 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 navigate the intricacies of the current processes and facilitate improvements.
• Strong organizational skills and attention to detail
• An ability to work with diverse internal and external constituencies
• A sense of urgency and an ability to understand priorities and anticipate needs while also being flexible in order to accommodate changes in priorities

Responsibilities

• Answers, screens and routes a high volume of phone and email inquiries from patients and families and external companies in coordination of clinical services.
• Records and forwards messages and triages calls to nurses, physicians and numerous other providers for urgent information or services.
• Schedules patient encounters and procedures to coordinate within and across providers in multiple specialties.
• Obtains and records required authorizations for prescription medication with insurance providers.
• Prepares requisitions and other standard forms as requested by clinician or supervisor.
• Communicates with other departments to coordinate ancillary clinical/administrative services.

Skills

Organizational skills

Attention to detail

Multi-party coordination

Prior authorization knowledge

Education

High School / GED

Some college or occupationally specific education/training

Job description

This position can be based in the following locations: Boston, Waltham, Needham, Weymouth, Peabody.

Position Summary:

Coordinates and facilitates administrative processes and services at a center or program necessary to deliver and support care for patients Supports the prior authorization process and scheduling for general providers and/or may train on more complex prior authorization processes, support more complex patients with specialized medications and treatments in support of patients with chronic diseases. Coordinates communications and services with insurance companies as directed. May assist with coordinating services with medical device and supply companies, and specialty pharmacy companies in support of providers' care.

Key Responsibilities:

Patient Encounter:

• Answers, screens and routes a high volume of phone and email inquiries from patients and families and external companies in coordination of clinical services. Records and forwards messages and triages calls to nurses, physicians and numerous other providers for urgent information or services. Initiates calls for emergency services as required.
• 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.
• Schedules patient encounters and procedures to coordinate within and across providers in multiple specialties. Obtains and records required authorizations for prescription medication with insurance providers. Verifies patient demographics. Collects all necessary clinical documentation and information.
• Collects and organizes medical records, information, materials and supplies required for admissions or encounters. Prepares requisitions and other standard forms as requested by clinician or supervisor. Communicates with other departments to coordinate ancillary clinical/administrative services. Prepares, routes and tracks routine administrative forms and documents.

Authorizations/Billing:

• Manages the prior authorization process for patients of general providers and/or may train on more complex prior authorization processes in support of multiple specialties. Prepares letters of medical necessity based on physician's notes.
• Coordinates appeals with clinicians and patient families by preparing letters of appeal or connecting the clinician directly with the insurance company.
• May serve as point of contact on the process for obtaining and responding to additional requests for prior authorizations for medicines across relevant insurance companies for supported clinical area.

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

Minimum Qualifications

Education:

• High School / GED required.
• Some college or occupationally specific education/training preferred.

Experience:

• 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 navigate the intricacies of the current processes and facilitate improvements
• Strong organizational skills and attention to detail
• An ability to work with diverse internal and external constituencies
• A sense of urgency and an ability to understand priorities and anticipate needs while also being flexible in order to accommodate changes in priorities

The posted pay range is Boston Children's reasonable and good-faith expectation for this pay at the time of posting.

Any base pay offer provided depends on skills, experience, education, certifications, and a variety of other job-related factors. Base pay is one part of a comprehensive benefits package that includes 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.