Insurance Coordinator

Fresenius Medical Care•Austin, TX

21h

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 adheres to the FMCNA Compliance Program and applicable regulatory and company policy requirements. The coordinator regularly meets with patients at assigned clinics to explain insurance options, assist with applications and enrollment, obtain premium statements and signatures, address changes in employment or other circumstances, and follow up on disputed claims. The role also helps patients assess eligibility for Medicare, Medicaid, and indigent assistance; monitors coverage and enrollment status; and maintains accurate insurance information for Accounts Receivable and billing. The position includes reviewing reports and audits, researching and correcting discrepancies, providing required monthly information to QA team members, and presenting insurance and financial assistance options when needed. Extensive local travel to clinics is required. The work involves desk and personal computer tasks as well as interaction with patients and facility staff in a healthcare facility.

Requirements

Bachelor's degree required.
Two to five years of related experience.
Excellent written and 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

Social Work or another healthcare-focused bachelor's degree.
Experience in the healthcare industry.
Experience with Medicare, Social Security, and Medicaid systems.
Past patient interaction.

Responsibilities

Meet regularly with dialysis patients at clinics in the assigned region to educate them about and coordinate insurance options.
Explain alternative insurance options, including Medicare, Medicaid, Medicare Supplement, State Renal programs, and COBRA.
Ensure patients follow through with insurance applications, obtain premium statements and signatures, and discuss options when employment status or other circumstances change.
Complete and follow up on paperwork for claims disputed for non-payment.
Collect documents and complete initial and annual indigent waiver applications.
Discuss insurance options when insurance contracts are terminated.
Determine Medicare eligibility by meeting with patients and contacting local Social Security offices.
Explain Medicare applications and assist eligible patients with the application process.
Act as liaison between patients and local agents regarding Medicare terminations and reinstatements.
Complete annual open enrollment and Medicare reinstatement paperwork with patients.
Track the 30-month coordination period each month for patients covered by employer Group Health Plans to ensure Medicare is in place when coordination ends.
Monitor and verify each patient's Medicaid status monthly and determine spend-down amounts.
Evaluate patients' personal financial information and determine eligibility for the indigent program.
Monitor patient insurance information to ensure it is current and accurate for the Accounts Receivable Department.
Address identified anomalies or discrepancies, research questions, and provide answers as needed.
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.
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 a monthly audit exam to remain current on internal policies.
Present insurance and financial assistance options to patients as needed.
Assist with projects assigned by the direct supervisor and perform other duties as assigned.