A biologic coordinator is an individual within a Dermatologist’s office who manages a patient’s journey from prescription to drug acquisition. This role navigates the complexities of patient access on behalf of those prescribed biologics. In addition to drug and disease education, BCs’ efforts entail communicating with insurance providers, completing enrollment forms, reviewing benefit verifications, submitting prior authorizations, writing appeals and letters of medical necessity, directing patient assistance and bridge programs, and coordinating all efforts of specialty pharmacies and manufacturer HUBs.
Essential Functions & Responsibilities:
- process of a prior authorization including, appeals, registering for copay cards, communicating with mandatory specialty pharmacies
- Keeps all tasks and patient list organized
- Works closely with pharmacies and insurance companies and is knowledgeable on the proper ways to communicate with these companies
- Full documentation of all communications
- Educate patients and respond to patient concerns promptly
- Contact patients with updated status or delays
- Knowledgeable with payer terminology including but not limited too, insurance claims, claim denials, overrides, quantity exceeded, etc.
- Keep up with biologic changes including new drugs, manufacturer/HUB changes, new indications, formulary changes with payers, etc.
- Prior authorizations for topical and oral medications (not biologics) completion
- Coordinates with provider for change of therapy if medication is denied by insurance
