Insurance Coordinator

About the Role

Explores, recommends, and coordinates insurance and potential financial assistance options for kidney dialysis patients in a specified geographic area, while maximizing revenue for the company. Supports the company's mission, vision, core values, and customer service philosophy. Adheres to the company's compliance program, including regulatory and policy requirements.

Responsibilities

• Meets regularly with dialysis patients at assigned clinics to educate and coordinate insurance options, including Medicare, Medicaid, Medicare Supplement, State Renal programs, and COBRA.
• Ensures patients complete the application process, obtain premium statements, and provide necessary signatures.
• Discusses insurance options when employment status or other situations change.
• Follows up on disputed claims for non-payment and completes necessary paperwork.
• Collects documents for initial and annual indigent waivers and evaluates patient financial information for indigent program eligibility.
• Determines Medicare eligibility, assists with applications, and acts as a liaison for terminations and reinstatements.
• Completes annual open enrollment and Medicare reinstatement papers with patients.
• Tracks the 30-month coordination period for patients on employer Group Health Plans to ensure Medicare is in place afterward.
• Monitors and verifies Medicaid status monthly, determines spend-down amounts, and addresses anomalies or discrepancies in insurance information.
• Meets with patients receiving direct payments from insurance companies to ensure payment for dialysis treatments.
• Prepares, analyzes, and reviews monthly reports to track caseload progress and audits patient reports for accurate insurance information.
• Provides QA team members with monthly updates on patients' insurance status and plans of action.
• Completes monthly audit exams to stay current on internal policies.
• Presents insurance and financial assistance options to patients as needed.
• Assists with various projects as assigned by the supervisor.

Qualifications

• Bachelor's Degree required; Social Work or other Healthcare focus preferred.
• 2 - 5 years of related experience; healthcare industry preferred.
• Experience with Medicare, Social Security, and Medicaid systems a plus.
• Past patient interaction a plus.
• Excellent written and communication skills.
• 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.

Physical Demands and Working Conditions

Day-to-day work includes desk and personal computer work, interaction with patients and facility staff, and extensive local travel to clinics in a specified geographic area. The work environment is characteristic of a healthcare facility with air temperature control and moderate noise levels. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.