Boston Scientific Pre-Authorization Specialist 

United States, Massachusetts, Marlborough 

218937931

About the role:The Pre-Authorization Specialist I is responsible for coordinating the Intake functions of the Patient Access Support Program (PASP). As the primary administrative support for the endobariatric patient access department, this role will complete all enrollment intake activities, coordination of files and medical records, and clerical support functions.

Your responsibilities will include:

• Answer incoming calls received through the toll-free PASP call center, providing superior customer service and appropriate call/case handling
• Process customer portal registrations in Salesforce
• Respond to production support inquiries presented by customer portal users
• Process new patient enrollments in Salesforce
• Create, maintain, and reconcile data records in Salesforce
• Retrieve, file, and organize all incoming documents from customers including enrollment forms, patient medical records and insurance information, actioning files appropriately
• Retrieve, file, and organize all incoming documents from payers including explanation of benefits, and prior authorization and appeal documents, actioning files appropriately
• Monitor the inbound email queue, responding and triaging inquiries appropriately
• Monitor the departmental fax queue to coordinate the intake of requests for services and action communication from customers, patients, and payers appropriately
• Contact physicians and/or patients to request missing information
• Assist in departmental meetings by taking minutes and coordinating distribution of the agenda
• Provide support and assistance for departmental projects involving heavy clerical and administrative responsibilities
• Report adverse events/product complaints following program Standard Operating Procedures (SOPs)
• Maintain PASP metrics and standards
• Comply with SOPs to maintain data integrity
• Maintain HIPAA compliance and patient confidentiality
• Engage and commit to the organization's culture of continuous improvement by actively participating, supporting, and promoting BSC Mission and Values
• Consistently provide superior quality and service in a high-volume work environment
• Opportunity for cross training in insurance benefits and coverage verification, and prior authorization functions
• Other duties as assigned

Required qualifications:

• High school diploma
• Minimum 1-year experience in an administrative function. Experience must include:
  • Reviewing documents and extracting key information
  • Answering customer/patient telephone calls
  • Proficient in Microsoft Word, Excel
• Strong written and verbal communication skills
• Detail-oriented professional that can efficiently prioritize and execute given tasks
• Travel <5%

Preferred qualifications:

• Associate’s degree
• Healthcare experience (Medical device preferred)
• Fluency in medical terminology

Maximum Salary: $ 62088

Compensation fornon-exempt (hourly), non-sales rolesmay also include variable compensation from time to time (e.g., any overtime and shift differential) and annual bonus target (subject to plan eligibility and other requirements).

Compensation forexempt, non-sales rolesmay also include variable compensation, i.e., annual bonus target and long-term incentives (subject to plan eligibility and other requirements).

For MA positions: It is unlawful to require or administer a lie detector test for employment. Violators are subject to criminal penalties and civil liability.

Please be advised that certain US based positions, including without limitation field sales and service positions that call on hospitals and/or health care centers, require acceptable proof of COVID-19 vaccination status. Candidates will be notified during the interview and selection process if the role(s) for which they have applied require proof of vaccination as a condition of employment. Boston Scientific continues to evaluate its policies and protocols regarding the COVID-19 vaccine and will comply with all applicable state and federal law and healthcare credentialing requirements. As employees of the Company, you will be expected to meet the ongoing requirements for your roles, including any new requirements, should the Company’s policies or protocols change with regard to COVID-19 vaccination.

Among other requirements, Boston Scientific maintains specific prohibited substance test requirements for safety-sensitive positions. This role is deemed safety-sensitive and, as such, candidates will be subject to a prohibited substance test as a requirement. The goal of the prohibited substance testing is to increase workplace safety in compliance with the applicable law.