Insurance Coordinator

Fresenius Medical Care•Hillsborough, NC

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 follows applicable regulatory and company policy requirements under the FMCNA Compliance Program. The coordinator meets with dialysis patients to explain insurance options, support applications and enrollment, collect required documents and signatures, address changes in employment or coverage, and help resolve disputed claims. The role also evaluates patients’ financial information for indigent assistance, tracks Medicare and Medicaid eligibility and status, and ensures insurance information is accurate and current for billing. The coordinator reviews reports, investigates discrepancies, provides information for quality-assurance processes, and completes monthly audit exams. Additional responsibilities may include presentations to patients, projects assigned by a direct supervisor, and other duties as assigned. The position involves desk and personal computer work, interaction with patients and facility staff, and extensive local travel to clinics in a specified geographic area. The work environment is a healthcare facility with controlled air temperature and moderate noise levels. A valid driver’s license is required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

Requirements

Bachelor’s degree required.
2–5 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

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

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 a patient’s employment status or other circumstances change, and when insurance contracts are terminated.
Complete and follow up on paperwork for disputed claims and non-payment.
Collect documents for initial and annual indigent waivers and complete and track indigent waiver applications.
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 a 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 monthly 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.
Evaluate patients’ personal financial information to determine eligibility for the indigent program.
Monitor patients’ insurance information for accuracy and currency for the Accounts Receivable Department; research and resolve anomalies and discrepancies.
Meet with patients receiving direct insurance payments to ensure payment for dialysis treatments owed to Fresenius.
Prepare, analyze, and review monthly caseload progress reports; audit patient reports from billing systems for accurate insurance information and identify overlooked changes.
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 a monthly audit exam to remain current on internal policies.
Present information on 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 specified geographic area.