Insurance Coordinator

Purpose and Scope 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. Principal Duties and Responsibilities Meet regularly with dialysis patients at the clinic(s) in the assigned region to educate and coordinate insurance options, including Medicare, Medicaid, Medicare Supplement, State Renal programs and COBRA. Ensure patients complete the application process and obtain premium statements and signatures. Discuss employment status changes or other circumstances that affect insurance coverage and complete relevant paperwork. Follow up on disputed claims for non-payment and complete necessary documents for initial and annual indigent waivers. Discuss insurance options when contracts are terminated and act as liaison between patients and local agents for Medicare terminations and reinstatements. Determine Medicare eligibility by meeting with patients and verifying with local Social Security offices. Assist eligible patients with the Medicare application process and complete annual open enrollment and reinstatement papers. Track the 30‑month coordinator period each month for 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 monthly, determine spend‑down amounts, and evaluate personal financial information for indigent program determinations. Track and complete annual indigent waiver applications. Monitor all patients’ insurance information for accuracy, research discrepancies, and update the Accounts Receivable Department. Meet with patients receiving direct payments from insurance companies to ensure dialysis treatments are paid to Fresenius. Prepare, analyze and review monthly reports to track caseload progress; analyze patient reports from billing systems, audit insurance information and correct discrepancies. Provide the QA team with monthly updates on patients’ primary and secondary insurance status and documentation of plans of action. Complete monthly audit exams to stay current on internal policies and may present on insurance and financial assistance options to patients as needed. Assist with various projects assigned by the direct supervisor and perform additional duties as assigned. Physical Demands and Working Conditions Day‑to‑day work includes desk and personal computer work and interaction with patients and facility staff. The work environment is characteristic of a healthcare facility with air‑temperature control and moderate noise levels. Extensive local travel to clinics in a specified geographic area is required; a valid driver’s license is mandatory. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education Bachelor’s Degree required; Social Work or other healthcare focus preferred. Experience and Required Skills 2–5 years of related experience; healthcare industry preferred. Experience with Medicare, Social Security and Medicaid systems is a plus. Past patient interaction experience is a plus. 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. Equal Opportunity Employer Fresenius Medical Care maintains a drug‑free workplace in accordance with applicable federal and state laws. Fresenius Medical Care is an equal‑opportunity employer and does not discriminate on the basis of race, color, religion, sexual orientation, gender identity, parental status, national origin, age, disability, military service, or other non‑merit‑based factors. #J-18808-Ljbffr