Medication Support Coordinator

Mass General Brigham•Boston, MA

2d•Hybrid

About The Position

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Requirements

High School Diploma or Equivalent required
Medical Office/Hospital/Managed Care experience 1-2 years required
Medication Administration/Pharmacy experience 1-2 years required
Experience with electronic medical record system(s) and Outlook preferred
Knowledge of laws and regulations related to clinical practice and patient confidentiality.
Knowledge of medication abbreviation and symbols, medication indication and dosage, and common medication questions.
Strong written and verbal communication skills.
Demonstrated skills in service excellence including active listening, problem solving and ability to remain calm in emotional situations.

Responsibilities

Accurately complete, process, and submit order forms and certificates of medical necessity for DME.
Coordinate with healthcare providers to ensure all clinical documentation precisely aligns with payer-specific DME coverage requirements.
Follow up routinely with DME vendors and insurance plans to track order status, resolve fulfillment delays, and ensure timely delivery to the patient.
Conduct one-on-one meetings with patients to explain insurance benefits, out-of-pocket costs, and available financial support options.
Complete, submit, and track applications for Patient Assistance Programs (PAP), foundation grants, and co-pay cards on behalf of eligible patients.
Guide patients through the access journey, clearly communicating the documentation required for medication and equipment approvals.
Processing and submitting prior authorizations, maintaining a high level of expertise in clinical criteria.
Investigate, draft, and respond to detailed daily inquiries from providers regarding insurance coverage guidelines, clinical criteria requirements, and denial management strategies.
Act as the primary escalation point for complex coverage issues, collaborating with clinical staff to formulate and submit successful appeals for denied therapies.