Insurance Coordinator

PURPOSE AND SCOPE:

Oversees the day to day activities of the Insurance Coordinators (IC's) providing direction, support and guidance as appropriate.

Assists the Insurance Coordinator Manager with the execution of the strategies and initiatives of the IC program within the assigned regions/Divisions.

Ensures the IC's are performing the required processes, procedures, and functions with regard to tracking, reporting, enrolling, and educating patients on their insurance options.

 Oversees the varied insurance financial assistance options according to the established timelines and standard operation procedures in compliance with company and regulatory guidelines and requirements.

Supports FMCNA's mission, vision, core values and customer service philosophy.

Adheres to the FMCNA Compliance Program, including following all regulatory and division/company policy requirements.

 

PRINCIPAL DUTIES AND RESPONSIBILITIES:


* Facilitates the execution of the Insurance Coordinator program providing for insurance preservation of dialysis patients by supervising the activities of the Insurance Coordinators (IC) ensuring each individual's work meets the established performance standards and customer service levels with regard to patient insurance education and enrollment.  Contributes to and ensures problem resolution by addressing and investigating escalated issues and complex problems.


* Provides guidance, direction, training, and support to Insurance Coordinators to ensure they are meeting the needs of the patients they serve and that they demonstrate insurance awareness of the issues in the Areas in which they work including eligibility and enrollment acting as a resource and subject matter expert as needed to ensure the proper and timely execution of the Insurance Coordinator program requirements.


* Reviews and audits Insurance Coordinator's data base reports to ensure compliance and productivity.  Reviews monthly reports submitted by IC's to ensure the patients are receiving the education, proper insurance enrollment, and assistance needed to secure optimal insurance coverage, AKF assistance, and/or Indigent waiver approval as necessary.
+ Coordinates and provides monthly Insurance Coordinator data base reports for the region communicating the results and escalates concerns to the IC Manager for review as necessary
+  Ensures accuracy of reports by comparing reports with the effective insurance reports.  Works with IC's regarding any missing information or discrepancies between reports.
+ Provides counseling and additional training to IC as necessary
+ Ensures accurate tracking and monitoring of Coordination of Benefit period and ensures that the Medicare applications are processed 90 days prior to the 30-month coordination period ending as required.
+ Monitors patients within the 6-month window of their 65th birthday, resulting in possible additional insurance enrollment and optimal...