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Sr Patient Administrative Coordinator
2 months ago
At Boston Children's Hospital, the quality of our care - and our inclusive hospital working environment - lies in the diversity of our people. With patients from local communities and 160 countries around the world, we're committed to reflecting the spectrum of their cultures, while opening doors of opportunity for our team. Here, different talents pursue common goals. Voices are heard and ideas are shared. Join us, and discover how your unique contributions can change lives. Yours included.
The Senior Patient Administrative Coordinator will be responsible for:
Payments and Authorizations
- Manage the authorization process for orthodontics. Prepare letters of medical necessity based on physician's notes.
- Collect co pays for bonding and/or retainers for private pay patients.
- Coordinate with insurance companies, specialty pharmacies and patient's families for the delivery of the specialized treatments during clinic visits.
- Coordinate appeals with clinicians and patient families by preparing letters of appeal or connecting the clinician directly with the insurance company.
- Obtain and respond to additional requests for prior authorizations across relevant insurance companies for orthodontics.
- Document any copayments due in future Epic appointment note.
Patient Encounters
- Answer, screen and route a high volume of phone and email inquiries from patients and families and external companies in coordination of services. Record and forward messages and triage calls to nurses, physicians and numerous other providers for urgent information or services. Initiate calls for emergency services as required.
- Respond to patient concerns and needs within scope of knowledge and authority and in accordance with our best practices and procedures. Respond 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.
- Schedule patient encounters and procedures after receiving consultation requests and referrals from Epic Workque and reviewing financials with patients and families.
- Obtain and record required authorizations on electronic or manual scheduling systems to compile and distribute patient and staff schedules. Verify patient demographics, insurance/payment and referral information for patient encounters. Collect all necessary clinical documentation and information.
- Collect and organize medical records, information, materials and supplies required for admissions or encounters.
- Collect and organize signed attendance/breakage policy contracts from families
- Update Orthodontics attendance tracker weekly to ensure we are in compliance with patients being seen every 6-8 weeks
Process Improvement
- Actively participates in and contributes to departmental and organizational initiatives and projects with a focus on continuous process improvement.
- Recommend and assists in schedule and financial optimization for orthodontics.
- Help reinforce scheduling and appointment policies with Front Desk/PER Call Center
*Schedule will be 32 hours per week Monday, Tuesday, Thursday, and Friday. 8:30am to 5pm*
To qualify you should have:
- 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.
- Some college or occupationally specific education/training.