76459BRJob Posting Title:Patient Administrative Coordinator - NephrologyDepartment:Medicine-NephrologyAutoReqId:76459BRStatus:Full-TimeStandard Hours per Week:40 Job Posting Category:Hospital OperationsJob Posting Description: Manage the prior authorization process for patients of general providers and/or may train on more complex prior authorization processes in support of multiple specialties. Prepare letters of medical necessity based on physician’s notes. Work under close supervision to provide support to the administrative operations in Nephrology and work to ensure the best possible patient experience by effectively coordinating services to patients and families.

The Patient Administrative Coordinator will:

• Manage 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.

• Coordinate 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.

• Answer, screen and routes a high volume of phone and email inquiries from patients and families and external companies in coordination of clinical services. Record and forward messages and triages calls to nurses, physicians and numerous other providers for urgent information or services. Initiate calls for emergency services as required.

• Respond to patient’s 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 to coordinate within and across providers in multiple specialties. Obtain and record required authorizations for prescription medication with insurance providers. Verify patient demographics. Collect all necessary clinical documentation and information.

• Collect and organize medical records, information, materials and supplies required for admissions or encounters. Prepare requisitions and other standard forms as requested by clinician or supervisor. Communicate with other departments to coordinate ancillary clinical/administrative services. Prepare, route and track routine administrative forms and documents.

• Actively participate in and contribute to departmental and organizational initiatives and projects with a focus on continuous process improvement.

• Recommend and assist in implementing change in internal systems and procedures.

  *Training will be 100% on site for two to three weeks. Following training, position will be hybrid with two to three days per week in office. *

  To qualify you should have:

• High School / GED

• Some college or occupationally specific education/training preferred.

• 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.

• Proactive communication skills.

• A sense of urgency and an ability to understand priorities and anticipate needs while also being flexible in order to accommodate changes in priorities.

  Office/Site Location:BostonRegular, Temporary, Per Diem:Regular Remote Eligibility :Part Remote/Hybrid