Insurance Coordinator

Fresenius Medical Care•Moline, IL

27d

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 choose insurance options that best fit their needs, supports FMCNA’s mission and customer service philosophy, and follows applicable compliance, regulatory, and company policy requirements. The coordinator meets with patients at clinics to explain insurance options, help with Medicare and Medicaid matters, track coverage and applications, and assist with indigent program determinations. The role also monitors the accuracy of patient insurance information, researches and corrects discrepancies, prepares and reviews reports and audits, and provides monthly information to QA team members. It involves desk and computer work, interaction with patients and facility staff, and extensive local travel to clinics in the assigned area.

Requirements

2–5 years of related experience; healthcare industry experience preferred.
A high school diploma requires a minimum of 5+ years of experience in a similar position or insurance 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 preferred; Social Work or another healthcare focus preferred.
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 and coordinate insurance options.
Educate patients about Medicare, Medicaid, Medicare Supplement, State Renal programs, COBRA, and other available insurance options.
Ensure patients follow through with insurance applications; obtain premium statements and patient signatures.
Discuss insurance options when a patient's employment status, circumstances, or insurance contracts change.
Complete and follow up on paperwork for disputed non-payment claims.
Collect documents needed to complete indigent waivers and complete initial indigent waiver applications.
Determine Medicare eligibility by meeting with patients and contacting local Social Security offices to verify eligibility.
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 and review insurance options during annual open enrollment and Medicare reinstatement periods.
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 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 accurate and updated for Revenue Cycle Management.
Address identified anomalies or discrepancies, research issues, and answer questions as needed.
Meet with patients receiving direct insurance payments to ensure they understand their responsibilities for handling those payments.
Prepare, analyze, and review monthly reports to track 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 a monthly audit exam 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.