Toxin Coordinator

Nira Medical

About The Position

The Toxin Coordinator is responsible for managing end-to-end order processing for Toxin services. This includes order intake, chart review, verifying insurance coverage and eligibility, submitting pre-authorizations, providing financial assistance support, ordering drugs, scheduling patients, and ensuring timely processing of Toxin appointments for an assigned physician's office.

Requirements

  • Performing 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.
  • Verifying and documenting insurance eligibility, benefits, and coverage for all toxin services.
  • Obtaining insurance authorization and pre-certification for toxin services.
  • Facilitating insurance denial mitigation steps such as peer-to-peer reviews and appeals.
  • Maintaining a good working knowledge of toxin drug authorization requirements for all payers, state and federal regulatory guidelines for coverage and authorization.
  • Calculating and communicating patient financial responsibility.
  • Providing financial assistance support to patients including identifying patient assistance programs and manufacturer copay assistance enrollment.
  • Communicating with patients and providers regarding the status of toxin order.
  • Scheduling patient appointments for toxin services.
  • Coordinating drug orders prior to toxin appointments, including both office stock and specialty pharmacy procurement.
  • Documenting office stock and sample vials used in inventory log.
  • Updating and maintaining toxin patient tracker.

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.
  • Obtain insurance authorization and pre-certification for toxin services.
  • Facilitate insurance denial mitigation steps such as peer-to-peer reviews and appeals.
  • Maintain 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.
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