Summary:

The Transcranial Magnetic Stimulation (TMS) Care Coordinator serves as the primary point of contact for patients throughout their TMS treatment journey. This role is responsible for conducting patient consultations, providing education regarding TMS therapy, managing insurance verification and prior authorizations, coordinating treatment scheduling, and supporting ongoing patient engagement and follow-up. This position also requires administration of TMS treatments under physician supervision, following established protocols.

 

The TMS Care Coordinator works closely with providers, clinical and non-clinical staff, insurance carriers, referral sources, and patients to ensure timely access to care and a positive treatment experience. This position plays a critical role in helping patients access life-changing treatment while ensuring an exceptional, supportive experience from initial consultation through completion of care. Administer TMS treatments under physician supervision, following established protocols.

Essential Duties and Responsibilities:

Insurance Authorization & Benefits Coordination

• Verify patient eligibility, benefits, and coverage for TMS services.
• Obtain and manage initial and continuing prior authorizations for TMS treatment.
• Collect, review, and organize clinical documentation necessary to support medical necessity requirements.
• Submit authorization requests and supporting documentation to insurance carriers.
• Monitor authorization status and proactively follow up on pending requests.
• Coordinate peer reviews, reconsiderations, and appeals as needed.
• Maintain accurate authorization records and ensure uninterrupted treatment approvals.
• Communicate insurance determinations, patient financial responsibilities, and treatment eligibility requirements to patients and providers.
• Maintain knowledge of payer-specific TMS coverage guidelines and authorization requirements. 
• May require occasional flexibility in scheduling to meet patient and operational needs.

Patient Consultation & Education

• Conduct consultations with prospective TMS patients to explain the treatment process and assess readiness for care.
• Educate patients and family members regarding TMS therapy, treatment expectations, scheduling commitments, and potential side effects.
• Review insurance coverage, authorization timelines, and financial responsibilities with patients.
• Serve as a resource for patient questions and concerns throughout the treatment process.
• Support informed decision-making by ensuring patients understand all aspects of treatment and care.
• Collaborate with providers to ensure consistent patient education and communication.

Patient Follow-Up & Care Coordination

• Serve as the primary liaison between patients, providers, and clinical staff throughout the course of treatment.
• Conduct routine follow-up calls and patient outreach to support treatment engagement and adherence.
• Coordinate care and communication with referring providers and internal clinical teams as appropriate.
• Document patient interactions, progress updates, and follow-up activities in the electronic health record (EHR).
• Promote a positive patient experience through responsive communication and compassionate support.
• Administer TMS treatments under physician supervision, monitor patient safety and response, educate patients, maintain equipment, and document care in the EHR according to clinical protocols.

Scheduling & Administrative Support

• Schedule consultations, treatment appointments, remapping sessions, and follow-up visits.
• Maintain provider and treatment schedules to optimize clinic efficiency and patient access.
• Ensure all required documentation is completed prior to treatment initiation.
• Assist with reporting, data tracking, and program performance metrics.
• Collaborate with billing staff to ensure accurate documentation and claim processing.
• Maintain compliance with HIPAA, company policies, and applicable regulatory requirements.

Qualifications:

Education

• High school diploma or equivalent required.
• Completion of a Medical Assistant program, healthcare certification, or other relevant healthcare training preferred.
• Associate’s degree in healthcare administration, Psychology, Behavioral Health, Medical Assisting, or a related field may be substituted for experience but is not required.

Experience

• Minimum of two (2) years’ experience in behavioral health, neurology or healthcare, preferred. 
• Experience with insurance verification, prior authorizations, and payer communications strongly      preferred.
• Experience using electronic health record (EHR) systems and practice management software preferred.

Certifications

• Medical Assistant certification (CMA, RMA, CCMA) preferred.
• Basic Life Support (BLS) certification preferred.
• TMS-specific training and certification will be provided upon hire.

 Physical Requirements

• Ability to sit, stand, and walk for extended periods.
• Ability to operate TMS equipment and computer systems.
• Ability to position treatment equipment and assist patients as needed.
• Ability to lift up to 25 pounds occasionally.