Insurance Coordinator

FMS USA Fresenius Mgmt Services Inc; Austin (TX); On-site; USD 60,000 - 85,000; Full time

Job summary

Fresenius Medical Care in Austin, TX seeks an Insurance Counselor to educate dialysis patients on insurance options and coordinate enrollment across Medicare, Medicaid, and related programs. You will liaise with patients, social workers, and insurers to verify eligibility, gather documents, and ensure smooth coverage transitions.

Responsibilities include managing annual open enrollment, assisting with applications, tracking spend down, and maintaining accurate insurance data for billing.

Qualifications

• 2–5 years of related experience in healthcare or insurance environments.
• Experience with Medicare, Social Security and Medicaid systems a plus.
• Past patient interaction is a plus; strong documentation and follow-up skills.
• Excellent written and verbal communication; strong customer service ethos.
• Proficient with PCs and Microsoft Office; valid driver’s license.

Responsibilities

• Meets with dialysis patients to educate and coordinate insurance options (Medicare/Medicaid, COBRA, state programs).
• Assists with Medicare/Medicaid applications and reinstatements and open enrollment.
• Monitors patient insurance status monthly and tracks spend down and indigent waivers.
• Completes required paperwork for claims disputes and indigent programs; maintains updated insurance data in billing systems.

Skills

Medicare knowledge

Customer service

Communication skills

Organization

Education

Bachelor's Degree

Healthcare focus preferred

Job description

PURPOSE AND SCOPE:

Explores, recommends, and coordinates the insurance and potential financial assistance options available to kidney dialysis patients in a specified geographic area, while maximizing revenue for the company. 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 completed initial and annual 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. Completing the annual open enrollment and Medicare reinstatement papers with the patients. Tracking 30-month coordinator 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 on a monthly basis 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. Tracks and completes annual indigent waiver applications. Monitors all patients' insurance information to ensure that it is updated and accurate for the Accounts Receivable Department. Addresses any identified anomalies or discrepancies, researches and answers questions as needed. Meets with patients receiving direct payments from insurance companies to ensure payment of dialysis treatments owed to Fresenius. 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 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 on a monthly basis as required by QA processes Completes monthly audit exam to stay current on internal policies. May present on insurance and financial assistance options to patients as necessary. Assist with various projects as assigned by direct supervisor. Other duties as assigned. Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions.

PHYSICAL DEMANDS AND WORKING CONDITIONS:

The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Day to day work includes desk and personal computer work and interaction with patients and facility staff. The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Extensive local travel to clinics in a specified geographic area; must have a valid Driver's License.

EDUCATION:

Bachelor's Degree required; Social Work or other Healthcare focus preferred.

EXPERIENCE AND REQUIRED SKILLS:

2 - 5 years' 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. A 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

Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.

Fresenius Medical Care is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sexual orientation, gender identity, parental status, national origin, age, disability, military service, or other non-merit-based factors

Creating a future worth living. For patients. Worldwide. Every day.

Fresenius Medical Care is the world's leading provider of products and services for individuals with kidney disease of which approximately 4.5 million patients worldwide regularly undergo dialysis treatment. United by a shared purpose of creating a future worth living for chronically and critically ill people, we care for around 292,000 dialysis patients around the globe. In addition, we operate around 35 global production sites to provide products such as dialysis machines, dialyzers, and related disposables. We aim to continuously improve our patients’ quality of life by offering them high-quality products as well as innovative technologies and treatment concepts.