Hospital Admissions/Prior Authorization Coordinator

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. Under general supervision, handles the complex coordination involved in scheduling patients for surgical procedures and hospital admissions for multiple clinicians. Coordinates with hospitals to get monthly schedule blocks for physicians and selects appropriate times for procedures. Ensures that all necessary documents and preparatory activities have been completed and that pertinent information is sent to the hospital prior to patients' admissions. Keeps current on the policies and procedures of a multitude of current insurance payors and hospitals. Delivers excellent customer service to patients. Serves as an internal resource as needed. Schedule: Monday-Friday, 8-hour shifts between the business hours of 7am-6pm. Schedule to be determined upon hire. Location: This role is Office-Based in MA. If you live in MA, you will enjoy the flexibility of a remote/office-based* role as you take on some tough challenges. Office-based schedule to be determined by manager upon hire. Will be required to work onsite 5 days/week for approximately first 60 days for training; training likely to be onsite in Chestnut Hill but will be determined upon hire.

Coordinates surgical bookings and hospital admissions for multiple clinicians either within the same or across multiple specialties and/or departments. Understands and effectively maneuvers the surgical booking process understanding and following the requirements for each hospital, insurance provider and clinician as well as applicable Atrius Health booking guidelines. Juggles and prioritizes various scheduling needs effectively Schedules patients for hospital admissions and surgical procedures. Coordinates and books operating room time and surgeon's time. Handles any needed rescheduling due to patient or facility conflicts. May work with other HACS and/or Atrius Health departments to resolve scheduling or booking conflicts Interacts with patients throughout the booking process, responding to requests and providing information in a timely and compassionate manner. Ensures patients understand all their pre- and post-operative appointments as well as any necessary testing prior to surgery (e.g., lab or radiology work). Ensures necessary written material accurately reflects these appointments and includes any directions or special instructions in correspondence. Accurately relays information between patients and clinicians, often dealing with high levels of patient frustration or anxiety Completes outside referral documents and obtains prior authorization for admission where applicable. Maintains and utilizes a thorough understanding and knowledge base of the different payors and the coverage they provide for surgeries. Ensures various requirements and procedures needed are met so that procedures can occur with minimal errors from an administrative standpoint. Keeps current with the changes in insurance company policies and procedures Ensures that all necessary documents and preparatory activities have been selected and forwards all pertinent information to the hospital prior to the patient's admission. Works with clinicians and primary care physicians to ensure appropriate pre-operative testing is done and facilitates medical clearance for the needed procedure Proactively ensures necessary information for admissions is available and processed correctly Maintains data and creates