Administrative Coordinator

GENERAL SUMMARY/ OVERVIEW STATEMENT:

The ALS Administrative Coordinator provides administrative support to health care providers in a high-volume at the ambulatory ALS Multidisciplinary Clinic at the Healey Center at Mass General Hospital. This role would function as the primary liaison between the patient and the providers for the prior authorizations for medications. The emphasis is placed on the ability to organize priorities, complete tasks, manage confidential patient information, and work with providers, patients, and insurance companies.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Responsible for:

• Follows department prior auth protocol and provides feedback on the process to supervisor.
• Obtaining prior authorizations and referrals, processing encounter forms and financial waivers, and patient billing issues.
• Completing all patient clinical care paperwork including but not limited to FMLA, prior authorizations, appeals and clinical work delegated by the nursing staff
• Ensures accuracy and completeness of all medication Prior Authorizations for the department.
• Follows through with patients, practices, providers, and back end. Assist Managers with projects and research as needed.
• Provides coverage obtaining authorizations and referrals for procedures and office visits as needed. Understands financial services and self-pay resources and provides patients with information as needed.
• Functions as a resource for patients around managed care plans, insurance, and referral issues, with an ability to perform electronic insurance verification.
• Completely performs and is a resource to other team members in all revenue enhancement activities, including but not limited to registration verification, co-payment collection, cash management, encounter form reconcilement, etc.
• Monitors EPIC encounter completion and works closing with providers to ensure timely completion of notes and billing.

Reviews schedules to ensure all patients scheduled have appropriate insurance, authorizations and referrals in place. Creates financial waivers for patients in clinic as needed.

• Obtains prior authorizations and referrals for all medications prescribed by providers in the practice for patient care.
• Maintains reports from MGPO and Hospital denials and claims that require further review and documentation.
• Ability to check EPIC for researching billing. Understands billing and the meaning of various entries into EPIC.

SKILLS/ABILITIES/COMPETENCIES REQUIRED:

• Knowledge of all HMO, Managed Care and other Third-Party Insurers.
• Careful attention to details
• Good organizational skills
• Ability to follow directions
• Good verbal and written communication skills
• Computer literacy
• Ability to demonstrate respect and professionalism for patients’ rights and individual needs

EDUCATION:

Bachelor’s Degree strongly preferred.

EXPERIENCE:

Minimum of 1 year of applicable experience.

WORKING CONDITIONS:

Office work during open clinic hours, Monday – Friday, 8:30am-5:00pm.