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Insurance Services Coordinator
vor 3 Monaten
POSITION SUMMARY:
This role is focused on assessing, recommending, and coordinating the insurance and financial assistance options available to patients undergoing kidney dialysis within a designated region, while optimizing revenue for the organization. The position aligns with Fresenius Medical Care's mission, vision, core values, and commitment to customer service excellence. Compliance with the FMCNA Compliance Program, as well as adherence to all regulatory and company policy standards, is essential.
KEY RESPONSIBILITIES:
Regularly engage with dialysis patients at clinics in the assigned area to inform and coordinate insurance alternatives:
- Provide education on various insurance options available, including Medicare, Medicaid, Medicare Supplement, State Renal programs, and COBRA.
- Assist patients in completing the application process.
- Collect premium statements and necessary signatures from patients.
- Discuss implications of changes in employment status or other relevant circumstances.
- Manage and follow up on paperwork for disputed claims.
- Gather required documentation to complete initial and annual indigent waivers.
- Review insurance options in the event of contract terminations.
Responsibilities related to Medicare and Medicaid include, but are not limited to:
- Assessing Medicare eligibility through patient meetings and liaising with local Social Security offices.
- Guiding eligible patients through the Medicare application process.
- Acting as a point of contact between patients and local agents regarding Medicare terminations and reinstatements.
- Completing annual open enrollment and Medicare reinstatement documentation with patients.
- Monitoring the 30-month coordination period for patients on employer Group Health Plans to ensure Medicare coverage is established post-coordination.
- Tracking and verifying the Medicaid status of patients monthly, including determining spend down amounts.
- Collaborating with patients to assess financial information for indigent program eligibility.
- Completing initial and annual indigent waiver applications.
- Maintaining accurate and updated insurance information for the Accounts Receivable Department.
- Addressing discrepancies and providing necessary research and answers.
- Meeting with patients receiving direct payments from insurance to ensure timely payment for dialysis services.
- Preparing and analyzing monthly reports to monitor progress on caseloads and auditing patient billing information for accuracy.
- Providing monthly updates to the QA team regarding patients' insurance statuses and action plans.
- Conducting monthly audits to remain compliant with internal policies.
- Presenting information on insurance and financial assistance options to patients as required.
- Assisting with various projects as directed by the supervisor.
- Performing other duties as assigned.
PHYSICAL DEMANDS AND WORK ENVIRONMENT:
The physical demands and characteristics of the work environment are representative of those encountered while performing essential job functions. Daily tasks involve desk work, computer usage, and interaction with patients and facility staff. The work environment is typical of a healthcare facility, featuring controlled air temperature and moderate noise levels. Reasonable accommodations may be made for individuals with disabilities to perform essential functions.
Frequent local travel to clinics within the designated area is required; a valid Driver's License is necessary.
EDUCATION:
- Bachelor's Degree required; a focus in Social Work or Healthcare is preferred.
EXPERIENCE AND REQUIRED SKILLS:
- 2 - 5 years of relevant experience; healthcare industry experience is preferred.
- Familiarity with Medicare, Social Security, and Medicaid systems is advantageous.
- Prior patient interaction experience is beneficial.
- Exceptional written and verbal communication skills.
- A strong commitment to customer service.
- Excellent organizational and time management abilities.
- Capability to work independently.
- Proficiency in Microsoft Office applications and PC usage.
- Valid Driver's License required.
EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity
Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.
COMPENSATION: The compensation for this position will be determined based on the successful candidate's qualifications, including education, work experience, skills, and competencies.
CAREER WITH A PURPOSE: We provide an opportunity to create and deliver treatments that positively impact lives. We support ongoing development and foster a dedicated team environment focused on achieving optimal healthcare outcomes.
INCLUSION AND DIVERSITY: Joining Fresenius Medical Care means being part of a team that values diversity and strives to create an inclusive atmosphere where all employees feel valued.
STABILITY: Our commitment to innovation and continuous improvement in renal therapies positions us as a market leader, providing employees with the stability and security necessary to enhance patient lives.
LEARNING AND DEVELOPMENT: We offer participation in programs at leading business schools, leadership development, and continuous training for healthcare professionals, ensuring access to high-quality educational resources.
LOCAL BENEFITS: We provide local benefits tailored to meet the needs of our employees, fostering personal growth and fulfillment.
WORK-LIFE BALANCE: We promote a better work-life balance through flexible working hours, part-time options, and remote work possibilities.