Insurance Coordinator

Fresenius Medical Care•Austin, TX

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 helping maximize company revenue. The role supports FMCNA’s mission, vision, core values, and customer service philosophy, and follows applicable regulatory and company policy requirements under the FMCNA Compliance Program. The coordinator meets with patients at assigned clinics to explain insurance options, support application and enrollment processes, obtain required documentation, address coverage changes and disputed claims, and assess eligibility for indigent assistance. The role also monitors insurance information for accuracy, reviews billing and patient reports, researches discrepancies, provides information for quality assurance processes, and may present insurance and financial assistance options to patients. Extensive local travel to clinics is required.

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.
Adherence to applicable regulatory requirements and company policies.

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.
Previous patient interaction is a plus.

Responsibilities

Meet regularly with dialysis patients at clinics in the assigned region to educate them about insurance and coordinate coverage options.
Explain options such as Medicare, Medicaid, Medicare Supplement, State Renal programs, and COBRA, and ensure patients follow through with applications.
Obtain premium statements and patient signatures; discuss coverage options when employment status or other circumstances change.
Complete and follow up on paperwork for disputed claims and non-payment issues.
Collect documents and complete initial and annual indigent waiver applications.
Determine Medicare eligibility by meeting with patients and contacting local Social Security offices; explain and assist with Medicare applications.
Act as liaison between patients and local agents regarding Medicare terminations and reinstatements, and complete annual open-enrollment and reinstatement paperwork.
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 patients’ Medicaid status monthly and determine spend-down amounts.
Review patients’ personal financial information and determine eligibility for the indigent program.
Keep patients’ insurance information updated and accurate for the Accounts Receivable Department; research and resolve anomalies or discrepancies.
Meet with patients receiving direct insurance payments to ensure payment for dialysis treatments owed to Fresenius.
Prepare, analyze, and review monthly reports tracking caseload progress; audit patient billing-system reports for correct insurance information and overlooked changes, and 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 exams to remain current on internal policies.
Present insurance and financial assistance options to patients as necessary.
Assist with projects assigned by the direct supervisor and perform other duties as assigned.
Travel extensively to clinics in the assigned geographic area.