Insurance Coordinator

Fresenius Medical Care•Galesburg, IL

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 the company’s mission, values, customer service philosophy, compliance program, and applicable policies and regulations. The coordinator regularly meets with patients at regional clinics to explain available insurance options, support applications, obtain premium statements and signatures, and help address changes in employment or other circumstances. The role also assists with disputed claims, indigent waivers, insurance contract terminations, and patients receiving direct insurance payments. Responsibilities include supporting Medicare and Medicaid eligibility and application processes, liaising with local agencies, reviewing enrollment and reinstatement options, tracking Medicare coordination periods, monitoring Medicaid status and spend-down amounts, and evaluating eligibility for indigent assistance. The coordinator maintains accurate insurance information for revenue cycle management, researches discrepancies, prepares and reviews monthly reports, provides information to QA team members, and completes monthly internal audit exams. The role may also present insurance and financial assistance options, assist with projects, and perform other assigned duties. The position involves desk and computer work, interaction with patients and facility staff, and extensive local travel to clinics. The work environment is a healthcare facility with controlled air temperature and moderate noise levels. A valid driver’s license is required. Supervision responsibilities: none. The job posting describes a comprehensive benefits package that includes medical, dental, and vision insurance, a 401(k) with company match, paid time off, and parental leave. It states that performance-based bonuses may apply to bonus-eligible positions.

Requirements

Two to five years of related experience; healthcare industry experience preferred.
A high school diploma is required if the candidate does not have a bachelor’s degree; candidates with a high school diploma must have at least five years of experience in a similar position or insurance 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.
Ability to perform desk and personal computer work and interact with patients and facility staff.
Ability to travel extensively to clinics in the assigned geographic area.

Nice To Haves

Bachelor’s degree preferred, with a preference for Social Work or another healthcare focus.
Healthcare industry experience preferred.
Experience with Medicare, Social Security, and Medicaid systems.
Past patient interaction.

Responsibilities

Meet regularly with dialysis patients at assigned regional clinics to educate 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 patient signatures.
Discuss insurance options when employment status or other circumstances change.
Complete and follow up on paperwork for disputed claims and non-payment.
Collect documents needed for indigent waivers and complete initial 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 to eligible patients and assist with the application process.
Act as liaison between patients and local agents regarding Medicare terminations and reinstatements.
Educate patients about and review insurance options during annual open enrollment and Medicare reinstatement periods.
Track the 30-month coordination period for patients with employer Group Health Plans to ensure Medicare is in place when the period ends.
Monitor and verify patients’ 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 accurate and current for Revenue Cycle Management.
Research and resolve identified anomalies or discrepancies and answer questions as needed.
Meet with patients receiving direct insurance payments to explain their responsibilities for handling those payments.
Prepare, analyze, and review monthly caseload progress reports; audit patient reports from billing systems and research and correct discrepancies.
Provide QA team members monthly details about patients’ primary and secondary insurance status and documentation of action plans, as required by QA processes.
Complete monthly audit exams to remain current on internal policies.
Present insurance and financial assistance options to patients as necessary.
Review and 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 within the specified geographic area.