Insurance Coordinator

Fresenius Medical Care•Moline, IL

25d

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. The role educates patients so they can select suitable insurance options and supports Fresenius Medical Care North America’s mission, vision, core values, and customer service philosophy. The coordinator must follow the company Compliance Program and all applicable regulatory and company policy requirements. The position involves regular meetings with dialysis patients at clinics in the assigned region, coordination of Medicare, Medicaid, and other insurance options, and evaluation of eligibility for financial assistance. The coordinator maintains accurate insurance information for Revenue Cycle Management, reviews reports and audits for discrepancies, and provides information to QA team members. The role also includes local travel among clinics, patient and facility staff interaction, and other duties or projects assigned by the direct supervisor. Supervision: None.

Requirements

2–5 years of related experience; healthcare industry experience preferred.
For applicants with a high school diploma, a minimum of 5+ years of experience in a similar position or insurance experience is required.
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.

Nice To Haves

Bachelor’s degree preferred; Social Work or another healthcare focus preferred.
Experience with Medicare, Social Security, and Medicaid systems.
Previous patient interaction.

Responsibilities

Meet regularly with dialysis patients at clinics in the assigned region to educate them about and coordinate insurance options.
Educate patients about alternative 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 insurance options when employment status or other circumstances change, and when insurance contracts are terminated.
Complete and follow up on paperwork for disputed claims involving non-payment.
Collect documents needed to complete indigent waivers and evaluate patients’ personal financial information to determine eligibility for the indigent program.
Determine Medicare eligibility by meeting with patients and contacting local Social Security offices; discuss and assist with Medicare applications.
Liaise between patients and local agents regarding Medicare terminations and reinstatements.
Educate patients on insurance options during annual open enrollment and Medicare reinstatement periods.
Track the 30-month coordination period monthly for patients covered by employer Group Health Plans to help ensure Medicare is in place when coordination ends.
Monitor and verify each patient’s Medicaid status monthly and determine spend-down amounts.
Monitor insurance information for accuracy and updates; investigate anomalies or discrepancies and answer questions as needed.
Meet with patients receiving direct payments from insurance companies to ensure they understand their responsibilities for handling those payments.
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.
Provide QA team members monthly details of patients’ primary and secondary insurance status and documentation of current action plans, as required by QA processes.
Complete monthly audit examinations to remain current on internal policies.
Present insurance and financial assistance options to patients as necessary.
Comply with the Code of Business Conduct, applicable company policies and procedures, and local, state, and federal laws and regulations.
Assist with projects assigned by the direct supervisor and perform other duties as assigned.
Travel extensively within the assigned geographic area to clinics; maintain a valid driver’s license.