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.