Insurance Coordinator

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 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.


* 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 discrepancies identif...