Boston, Massachusetts

Job Posting Description

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 Patient Administrative Coordinator will be responsible for:
  • Authorizations:
    • Managing the prior authorization process for patients of subspecialists across multiple specialties. Preparing letters of medical necessity based on physician’s notes.
    • Coordinating 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.
  • Patient Encounters:
    • Answering, screening and routing a high volume of phone and email inquiries from patients, families and external companies in coordination of clinical services. Recording and forwarding messages and triaging calls to nurses and physicians. Initiating calls for emergency services as required.
    • Responding to patient’s concerns and needs within scope of knowledge and authority and in accordance with best practices and procedures. Responding to situations requiring escalated service response.
    • Scheduling patient encounters and procedures to coordinate within and across providers in multiple specialties. Obtaining and recording required authorizations for prescription medication with insurance providers. Verifying patient demographics. Collecting all necessary clinical documentation and information.
    • Collecting and organizing medical records, information, materials and supplies required for admissions or encounters. Preparing requisitions and other standard forms as requested by clinician or supervisor. Communicating with other departments to coordinate ancillary clinical/administrative services. Preparing, routing and tracking routine administrative forms and documents.
  • Process Improvement:
    • Actively participating in and contributing to departmental and organizational initiatives and projects with a focus on continuous process improvement.
    • Recommending and assisting in implementing change in internal systems and procedures.

To qualify, you must have:
  • A high school diploma required. Some college or occupationally-specific education/training preferred.
  • Minimum of 1 year in a high volume administrative role with an emphasis on problem resolution among multiple internal and/or external parties.
  • Ability to learn prior authorization process for medicines sufficient to navigate the intricacies of the current processes and facilitate improvements. 
  • Strong organizational skills and attention to detail. 
  • Ability to solve problems but with a keen sense of when to escalate for appropriate resolution.

Please note: During a public health emergency, individuals in this role may be expected to take on additional duties to respond to organizational needs.

Boston Children’s Hospital offers competitive compensation and unmatched benefits, including affordable health, vision and dental insurance, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition Reimbursement, cell phone plan discounts and discounted rates on T-passes (50% off). Discover your best.

Boston Children’s Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.

Boston, Massachusetts

Boston Children's Hospital is a 404-bed comprehensive center for pediatric health care. As one of the largest pediatric medical centers in the United States, Boston Children's offers a complete range of health care services for children from birth through 21 years of age. (Our services can begin interventions at 15 weeks gestation and in some situations we also treat adults.)

We have approximately 25,000 inpatient admissions each year and our 200+ specialized clinical programs schedule 557,000 visits annually. Last year, the hospital performed more than 26,500 surgical procedures and 214,000 radiological examinations.

Our team of physicians and nurses has been recognized by a number of independent organizations for overall excellence, and we're proud to share some notable examples with you here.

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