Insurance Coordinator

Fresenius Medical Care•Carrboro, NC

About The Position

The Insurance Coordinator explores, recommends, and coordinates insurance and potential financial assistance options for kidney dialysis patients in an assigned geographic area, while maximizing company revenue. The role supports FMCNA’s mission, vision, core values, and customer service philosophy and complies with applicable regulatory and company policy requirements. The coordinator regularly meets with patients at assigned clinics to explain insurance options, help with applications and enrollment, monitor coverage status, resolve claim and payment issues, and evaluate eligibility for financial assistance. The position also maintains accurate insurance information for Accounts Receivable, reviews reports and audits for discrepancies, and provides documentation to QA team members. The work includes desk and computer tasks, interaction with patients and facility staff, and extensive local travel to clinics. A valid driver’s license is required.

Requirements

Bachelor’s degree required.
Two to five years of related experience.
Excellent written and verbal communication skills.
Strong customer service philosophy.
Strong organizational and time-management skills.
Ability to work independently.
Proficiency with PCs and Microsoft Office applications.
Valid driver’s license.
Comply with applicable regulatory and company policy requirements.

Nice To Haves

Bachelor’s degree in Social Work or another healthcare-focused field preferred.
Healthcare industry experience preferred.
Experience with Medicare, Social Security, and Medicaid systems is a plus.
Past patient interaction is a plus.

Responsibilities

Meet regularly with dialysis patients in assigned clinics to educate them about and coordinate available insurance options, including Medicare, Medicaid, Medicare Supplement, State Renal programs, and COBRA.
Ensure patients follow through with insurance applications; obtain premium statements and patient signatures; discuss options when employment or other circumstances change.
Complete and follow up on paperwork for disputed claims involving non-payment, and discuss options when insurance contracts are terminated.
Collect documents for initial and annual indigent waivers and complete and track indigent waiver applications.
Determine Medicare eligibility by meeting with patients and contacting local Social Security offices; explain and assist with applications.
Liaise between patients and local agents concerning Medicare terminations and reinstatements, and complete annual open-enrollment and reinstatement paperwork with patients.
Track the 30-month coordination period for patients covered by employer Group Health Plans to help ensure Medicare is in place when coordination ends.
Monitor and verify Medicaid status monthly and determine spend-down amounts.
Review patients’ financial information and determine eligibility for the indigent program.
Monitor patient insurance information for accuracy and completeness for the Accounts Receivable Department; research and resolve anomalies and discrepancies.
Meet with patients receiving direct insurance payments to ensure payment for dialysis treatments owed to Fresenius.
Prepare, analyze, and review monthly reports to track caseload progress; audit patient reports from billing systems to verify insurance information and identify overlooked changes.
Research and correct discrepancies found in billing-system reports.
Provide QA team members monthly information about patients’ primary and secondary insurance status and documentation of current action plans, as required by QA processes.
Complete monthly audit exams to stay current on internal policies.
Present information about insurance and financial assistance options to patients as needed.
Assist with projects assigned by the direct supervisor and perform other duties as assigned.
Travel extensively to clinics in the assigned geographic area.