Insurance Coordinator

Fresenius Medical Care • Galesburg, IL

3d

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 insurance options that best meet their needs, while supporting FMCNA’s mission, vision, core values, and customer service philosophy. The coordinator follows the FMCNA Compliance Program and applicable regulatory and company requirements.

The coordinator meets regularly with patients at assigned clinics to explain insurance options, support applications, obtain premium statements and signatures, address changes in employment or other circumstances, resolve disputed claims, and collect documentation for indigent waivers. Responsibilities include supporting Medicare and Medicaid eligibility and applications, liaising with local agents regarding Medicare terminations and reinstatements, reviewing enrollment options, tracking employer-plan coordination periods, and monitoring Medicaid status and spend-down amounts. The role also evaluates patient financial information for indigent program determinations and completes initial waiver applications.

The coordinator maintains accurate insurance information for Revenue Cycle Management, investigates discrepancies, and helps patients understand their responsibilities when receiving direct insurance payments. The role prepares and analyzes monthly caseload reports, audits billing-system insurance records, provides required monthly information to QA team members, and completes monthly audit exams to stay current on internal policies. The position may also present insurance and financial assistance options, assist with projects assigned by the direct supervisor, and perform other duties as assigned. Additional responsibilities may focus on one or more departments or locations.

The work includes desk and personal computer tasks and interaction with patients and facility staff in a healthcare facility. Extensive local travel to clinics in the assigned geographic area is required, and a valid driver’s license is required. The position has no supervisory responsibilities.

Requirements

• High school diploma or equivalent; candidates with a high school diploma require at least 5 years of experience in a similar position or insurance experience.
• 2–5 years of related experience; healthcare industry experience preferred.
• Valid driver’s license.
• 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.

Nice To Haves

• Bachelor’s degree preferred, with a preference for Social Work or another healthcare-focused field.
• 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 insurance options and coordinate coverage.
• 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 patient signatures.
• Discuss insurance options when employment status or other circumstances change.
• Complete and follow up on paperwork for disputed non-payment claims.
• Collect documentation needed to complete indigent waivers.
• Discuss options when insurance contracts are terminated.
• Determine Medicare eligibility by meeting with patients and contacting local Social Security offices.
• Discuss Medicare applications with eligible patients and assist with the application process.
• Act as liaison between patients and local agents regarding Medicare terminations and reinstatements.
• Educate patients about insurance options during annual open enrollment and Medicare reinstatement periods.
• Track the 30-month coordination period for patients with 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.
• Evaluate patients’ personal financial information and determine eligibility for the indigent program; complete initial indigent waiver applications.
• Monitor patient insurance information to ensure it is updated and accurate for Revenue Cycle Management.
• Investigate and resolve identified anomalies or discrepancies and answer related questions.
• Meet with patients receiving direct insurance payments to explain their responsibilities for handling those payments.
• Prepare, analyze, and review monthly reports tracking caseload work 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 plans of action as required by QA processes.
• Complete monthly audit exams to stay current on internal policies.
• Present insurance and financial assistance options to patients as necessary.
• Comply with the Code of Business Conduct, company policies and procedures, and applicable local, state, and federal laws and regulations.
• Assist with projects assigned by the direct supervisor and perform other duties as assigned.
• Travel extensively to clinics in the assigned geographic area.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• 401(k) with company match
• Paid time off
• Parental leave
• Potential performance-based bonuses, depending on company and individual performance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED