FMCNA
Healthcare
InsuranceCoordinator
Neural analysis suggests this role is
optimal for Mid+ candidates.
“Insurance Coordinator at FMCNA. Skills: insurance coordination, patient education, Medicare, Medicaid. Explores, recommends, and coordinates insurance and potential financial assistance options available to kidney dialysis patients. Provides patients education to elect the best insurance options for them”
Industry & Context.
Addresses any identified anomalies or discrepancies, research and answers questions as needed; Researches and corrects any discrepancies identified
Extensive local travel to clinics in a specified geographic, Must have a valid Driver’s License
What They're Looking For.
Must Have
High school diploma would require minimum of 5+ years of experience in similar position or insurance experience, Valid Driver’s License
Nice to Have
Bachelor’s Degree preferred, Social Work or other Healthcare focus preferred, 2 – 5 years’ related healthcare industry preferred, Experience with Medicare, Social Security and Medicaid systems a plus, Past patient interaction a plus
What You'll Do.
and coordinates insurance and potential financial assistance options available to kidney dialysis patients
Provides patients education to elect the best insurance options for them
Meets regularly with dialysis patients at the clinic(s) to educate and coordinate insurance options
Educates on the availability of alternative insurance options
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 indigent waivers
Discusses insurance options when insurance contracts are terminated
Determining Medicare eligibility
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
Educate and review insurance options for annual open enrollment and Medicare reinstatement periods with patients
Tracking 30-month coordination 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 monthly 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
Monitors all patients’ insurance information to ensure that it is updated and accurate for the Revenue Cycle Management
Addresses any identified anomalies or discrepancies
research and answers questions as needed
Meets with patients receiving direct payments from insurance companies to ensure patients understand their responsibility with the handling of those payments
and reviews monthly reports to track work progress
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 discrepancies identified
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 monthly as required by QA processes
Completes monthly audit exam to stay current on internal policies
May present insurance and financial assistance options to patients as necessary
Review and comply with the Code of Business Conduct and all applicable company policies and procedures
Assist with various projects as assigned by direct supervisor
Other duties as assigned
How You'll Work.
Team & Collaboration
interaction with patients and facility staff; Provides QA team members with monthly information
Communication Scope
Excellent written and communication skills
Full Job Description
**_PURPOSE AND SCOPE:_** Explores, recommends, and coordinates insurance and potential financial assistance options available to kidney dialysis patients in a specified geographic area, while providing our patients education to elect the best insurance options for them. 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:_** * 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 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 indigent waivers. * Discusses insurance options when insurance contracts are terminated. * 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 eligibility. * 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. * Educate and review insurance options for annual open enrollment and Medicare reinstatement periods with patients. * Tracking 30-month coordination 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 monthly and determ
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