Insurance Coordinator

Insurance Coordinator –
Fresenius Medical Care

Explores, recommends, and coordinates the insurance and potential financial assistance options available to kidney dialysis patients in a specified geographic area, while maximizing revenue for the company. Supports FMCNA’s mission, vision, core values, and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and company policy requirements.

• Meet regularly with dialysis patients at the clinic(s) in the assigned region to educate and coordinate insurance options.
• Educates on the availability of alternative insurance options (i.e., Medicare, Medicaid, Medicare Supplement, State Renal programs and COBRA).
• Ensures patients have followed through with the application process.
• Obtains premium statements and signatures from patients.
• Discusses situation and options if employment status changes or other situations change.
• Completes and follows up with paperwork when claims are disputed for non‑payment.
• Collects necessary documents to complete initial and annual indigent waivers.
• Discusses insurance options when insurance contracts are terminated.
• Determine Medicare eligibility by meeting with the patients and contacting local Social Security offices to verify eligibility.
• Discuss the Medicare application with eligible patients and assist with the application process.
• Act as liaison between the patient and the local agents for Medicare terminations and re‑in statements.
• Complete the annual open enrollment and Medicare reinstatement papers with the patients.
• Track 30‑month coordinator period each month for those patients on employer Group Health Plans to ensure Medicare will be in place once coordination ends.
• Monitor and verify the Medicaid status of each patient on a monthly basis and determine the spend‑down amounts.
• Work with patients to evaluate personal financial information and make determination for indigent program.
• Complete initial indigent waiver applications.
• Track and complete annual indigent waiver applications.
• Monitor all patients’ insurance information to ensure that it is updated and accurate for the Accounts Receivable Department.
• Address any identified anomalies or discrepancies, research and answer questions as needed.
• Meet with patients receiving direct payments from insurance companies to ensure payment of dialysis treatments owed to Fresenius.
• Prepare, analyze, and review monthly reports to track work progress on caseloads; analyze patient reports from billing systems as an audit check to ensure the correct insurance information is entered into the billing system and that other changes are not overlooked. Research and correct any discrepancies identified.
• Provide QA team members with monthly information regarding the details of the patients’ primary and secondary insurance status as well as documentation regarding the plans of action currently in place on a monthly basis as required by QA processes.
• Complete monthly audit exam to stay current on internal policies.
• May present on insurance and financial assistance options to patients as necessary.
• Assist with various projects as assigned by direct supervisor.
• Other duties as assigned.

Day‑to‑day work includes desk and personal computer work and interaction with patients and facility staff. The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. Extensive local travel to clinics in a specified geographic area; must have a valid driver’s license. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Bachelor’s Degree required;
  Social Work or other Healthcare focus preferred.

• 2–5 years related experience; healthcare industry preferred.
• Experience with Medicare, Social Security, and Medicaid systems a plus.
• Past patient interaction a plus.
• Excellent written and communication skills.
• A strong customer service philosophy.
• Strong organizational and time‑management skills.
• Ability to work independently.
• Proficient with PCs and Microsoft Office applications.
• Valid driver’s license.

Fresenius Medical Care maintains a drug‑free workplace in accordance with applicable federal and state laws.

EOE, disability/veterans