Insurance Coordinator Jobs

PURPOSE AND SCOPE:

Explores, recommends, and coordinates the insurance and potential financial assistance options available to kidney dialysis patients in a specified geographic area, while maximizing revenue for the company. Supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and company policy requirements

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Meets regularly with dialysis patients at the clinic(s) in the assigned region to educate and coordinate insurance options:

• Ensures patients have followed through with the application process.
• Discusses situation and options if employment status changes or other situations change.
• Collects necessary documents to completed initial and annual indigent waivers.
• Completes and follows up with paperwork when claims are disputed for non-payment.
• Obtains premium statements and signatures from patients.
• Educates on the availability of alternative insurance options (i.e., Medicare, Medicaid, Medicare Supplement, State Renal programs and COBRA).
• Discusses insurance options when insurance contracts are terminated.

Responsibilities involving Medicare and Medicaid include but are not limited to:

• Tracking 30-month coordinator period each month for those patients on employer Group Health Plans to ensure Medicare will be in place once coordination ends.
• Acting as liaison between the patient and the local agents for Medicare terminations and re-in statements.
• Meets with patients receiving direct payments from insurance companies to ensure payment of dialysis treatments owed to Fresenius.
• Assist with various projects as assigned by direct supervisor.
• Monitors all patients' insurance information to ensure that it is updated and accurate for the Accounts Receivable Department.
• Prepares, analyzes and reviews monthly reports to track work progress on caseloads; Analyzes patient reports from billing systems as an audit check to ensure the correct insurance information is entered into the billing system and that other changes are not overlooked. Researches and corrects any discrepancies identified.
• Provides QA team members with monthly information regarding the details of the patients' primary and secondary insurance status as well as documentation regarding the plans of actions currently in place on a monthly basis as required by QA processes
• Addresses any identified anomalies or discrepancies, researches and answers questions as needed.
• Discussing the Medicare application with eligible patients and assisting with the application process.
• Completing the annual open enrollment and Medicare reinstatement papers with the patients.
• Other duties as assigned.
• May present on insurance and financial assistance options to patients as necessary.
• Completes initial Indigent waiver applications.
• Monitoring and verifying the Medicaid status of each patient on a monthly basis and determining the spend down amounts
• Works with patients to evaluate personal financial information and make determination for indigent program.
• Tracks and completes annual indigent waiver applications.
• Determining Medicare eligibility by meeting with the patients and contacting local Social Security offices to verify eligibility.
• Completes monthly audit exam to stay current on internal policies.

Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions.

PHYSICAL DEMANDS AND WORKING CONDITIONS:

The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Day to day work includes desk and personal computer work and interaction with patients and facility staff. The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Extensive local travel to clinics in a specified geographic area; must have a valid Driver's License.

EDUCATION:

• Bachelor's Degree required; Social Work or other Healthcare focus preferred.

EXPERIENCE AND REQUIRED SKILLS:

• Past patient interaction a plus.
• Proficient with PCs and Microsoft Office applications.
• Experience with Medicare, Social Security and Medicaid systems a plus.
• A strong customer service philosophy.
• Ability to work independently.
• Valid Driver's License
• Excellent written and communication skills.
• 2 - 5 years' related experience; healthcare industry preferred.
• Strong organizational and time management skills.

EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity

Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.