Healthcare Insurance Coordinator
Company: Fresenius Medical Care
Posted on: June 8, 2021
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
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Meets 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
- 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 completed initial and annual
- Discusses insurance options when insurance contracts are
Responsibilities involving Medicare and Medicaid include but are
not limited to:
- Determining Medicare eligibility by meeting with the patients
and contacting local Social Security offices to verify
- Discussing the Medicare application with eligible patients and
assisting with the application process.
- Acting as liaison between the patient and the local agents for
Medicare terminations and re-in statements.
- Completing the annual open enrollment and Medicare
reinstatement papers with the patients.
- Tracking 30-month coordinator period each month for those
patients on employer Group Health Plans to ensure Medicare will be
in place once coordination ends.
- Monitoring and verifying the Medicaid status of each patient on
a monthly basis and determining the spend down amounts
- Works with patients to evaluate personal financial information
and make determination for indigent program.
- Completes initial Indigent waiver applications.
- Tracks and completes annual indigent waiver applications.
- Monitors all patients' insurance information to ensure that it
is updated and accurate for the Accounts Receivable
- Addresses any identified anomalies or discrepancies, researches
and answers questions as needed.
- Meets with patients receiving direct payments from insurance
companies to ensure payment of dialysis treatments owed to
- Prepares, analyzes and reviews monthly reports to track work
progress on caseloads; Analyzes 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. Researches and corrects any
- Provides 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 actions currently in
place on a monthly basis as required by QA processes
- Completes monthly audit exam to stay current on internal
- May present on insurance and financial assistance options to
patients as necessary.
- Assist with various projects as assigned by direct
- Other duties as assigned.
Additional responsibilities may include focus on one or more
departments or locations. See applicable addendum for department or
location specific functions.
PHYSICAL DEMANDS AND WORKING CONDITIONS:
The physical demands and work environment characteristics
described here are representative of those an employee encounters
while performing the essential functions of this job. 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. Reasonable accommodations may be made to enable
individuals with disabilities to perform the essential
Extensive local travel to clinics in a specified geographic
area; must have a valid Driver's License.
- Bachelor's Degree required; Social Work or other Healthcare
EXPERIENCE AND REQUIRED SKILLS:
- 2 - 5 years' related experience; healthcare industry
- Experience with Medicare, Social Security and Medicaid systems
- 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
EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual
Fresenius Medical Care North America maintains a drug-free
workplace in accordance with applicable federal and state laws.
Keywords: Fresenius Medical Care, Stockton , Healthcare Insurance Coordinator, Other , Stockton, California
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