Pre-Authorization Specialist I

Additional Location(s):  N/A

Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - High Performance

At Boston Scientific, we’ll give you the opportunity to harness all that’s within you by working in teams of diverse and high-performing employees, tackling some of the most important health industry challenges. With access to the latest tools, information and training, we’ll help you in advancing your skills and career. Here, you’ll be supported in progressing – whatever your ambitions.           

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

Requisition ID: 602727 

Minimum Salary: $ 36504 

Maximum Salary: $ 62088 

The anticipated compensation listed above and the value of core and optional employee benefits offered by Boston Scientific (BSC) – see www.bscbenefitsconnect.com--will vary based on actual location of the position and other pertinent factors considered in determining actual compensation for the role. Compensation will be commensurate with demonstrable level of experience and training, pertinent education including licensure and certifications, among other relevant business or organizational needs. At BSC, it is not typical for an individual to be hired near the bottom or top of the anticipated salary range listed above.

Compensation for non-exempt (hourly), non-sales roles may 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 for exempt, non-sales roles may 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.

As a leader in medical science for more than 40 years, we are committed to solving the challenges that matter most – united by a deep caring for human life. Our mission to advance science for life is about transforming lives through innovative medical solutions that improve patient lives, create value for our customers, and support our employees and the communities in which we operate. Now more than ever, we have a responsibility to apply those values to everything we do – as a global business and as a global corporate citizen.

So, choosing a career with Boston Scientific (NYSE: BSX) isn’t just business, it’s personal. And if you’re a natural problem-solver with the imagination, determination, and spirit to make a meaningful difference to people worldwide, we encourage you to apply and look forward to connecting with you!

At Boston Scientific, we recognize that nurturing a diverse and inclusive workplace helps us be more innovative and it is important in our work of advancing science for life and improving patient health. That is why we stand for inclusion, equality, and opportunity for all. By embracing the richness of our unique backgrounds and perspectives, we create a better, more rewarding place for our employees to work and reflect the patients, customers, and communities we serve. 

Boston Scientific Corporation has been and will continue to be an equal opportunity employer. To ensure full implementation of its equal employment policy, the Company will continue to take steps to assure that recruitment, hiring, assignment, promotion, compensation, and all other personnel decisions are made and administered without regard to race, religion, color, national origin, citizenship, sex, sexual orientation, gender identify, gender expression, veteran status, age, mental or physical disability, genetic information or any other protected class.

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.