The Toxin coordinator is responsible for managing end-to-end order processing for Toxin services, including order intake, chart review, verifying insurance coverage and eligibility, submitting pre-authorizations, financial assistance support, drug ordering, patient scheduling, and ensuring timely processing of Toxin appointments for an assigned physician's office.
Key Responsibilities
-
Perform intake duties for toxin orders including reviewing orders and adding patients to patient tracker, obtaining clinical requirements, and communicating with prescribers regarding required clinical documentation.
-
Verify and document insurance eligibility, benefits, and coverage for all toxin services.
-
Obtains insurance authorization and pre-certification for toxin services.
-
Facilitate insurance denial mitigation steps such as peer-to-peer reviews and appeals.
-
Maintains a good working knowledge of toxin drug authorization requirements for all payers, state and federal regulatory guidelines for coverage and authorization.
-
Calculate and communicate patient financial responsibility.
-
Provide financial assistance support to patients including identifying patient assistance programs and manufacturer copay assistance enrollment.
-
Communicate with patients and providers regarding the status of toxin order.
-
Schedule patient appointments for toxin services.
-
Coordinate drug orders prior to toxin appointments, including both office stock and specialty pharmacy procurement.
-
Document office stock and sample vials used in inventory log.
-
Update and maintain toxin patient tracker.