Insurance Coordination Manager, Specialized Teams

PURPOSE AND SCOPE: Develop and implement 'Insurance Coordinator Specialist' role to enhance the effectiveness and consistency within the Insurance Coordination (IC) Team. This team will aim to elevate performance standards and strengthen partnerships across the IC function. This role will provide support in tasks as noted below, with expectation to expand:

New Hire Training Program

• Design and implement a comprehensive onboarding and training program for new hires within the IC Team.
• Establish a support structure, including dedicated trainers to ensure successful integration and performance

IC Float Role Development

• Create a flexible "IC Float" position to provide coverage during staff vacancies, leaves of absence, and other operational gaps.
• Define clear workflows, performance expectations, goals, and metrics to ensure continuity of patient support services.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Assists Insurance Coordination leadership in executing strategies and initiatives that support the mission and values of the company.
• Provide leadership and direction to Insurance Coordinators, ensuring achievement of program goals.  Drives the implementation of national IC program initiatives and strategies, including establishment of strategic direction for growth of the IC Program, and ultimately, the growth of business.
• Ensures appropriate training and education for the IC staff in support of development of the required skill sets and compliance within company policies and procedures.  Provides guidance regarding procedures, process improvement and efficiencies to effectively and optimally resolve issues.

• Manages workflow procedures and service levels.  Conducts audits to evaluate individual and team work progress and conducts ongoing analyses and assessments of operational performance for continuous systems and process improvements, improved efficiency, and improved internal and external customer satisfaction.

  • Implements communication procedures, systems, and technology as appropriate to improve program efficacy
  • Promotes collaboration between Insurance Coordinator program team members, clinics, billing groups, and Operations, and other internal functions to ensure patient needs are met
  • May intercede in complex situations (uninsured, undocumented, or legal resident aliens) to provide Operations with pertinent patient data to assist with the admission process/decision
  •  Reviews trends and monthly variances in reporting of monthly metrics, researching significant reporting discrepancies, to ensure data integrity

• Provides the appropriate support and guidance to ensure accurate insurance is loaded into the billing system and to avoid premature loss of insurance

  • Conducts monthly meetings with IC Supervisors to review reports, best practices, program changes and adherence, strengths, opportunities for improvement, training/education, to ensure proper program consistency within the Division. 

• Oversees the monitoring and evaluation of operational policies and procedures including setting goals, standards, and benchmarks to evaluate staff performance and patient satisfaction through Quality Assurance audits and metrics reporting.

  • Provides leadership and direction to the IC Supervisors providing informal feedback throughout the year and formally through the annual performance evaluation process
  • Manages the department staffing through the appropriate hiring, terminating, disciplinary action and employee retention process
  • Oversees the orientation, training, and coaching of new and current staff - Insurance Coordinators, Supervisors and other Department staff - ensure IC program goals and objectives are met
  • Facilitates department staff relationships with both internal and external customers through provision of experiential training, monthly conference calls and/or webexes, periodic visits, and annual educational programs at the Division office.
  • Collaborates extensively with operations management leadership and other operational managers to ensure optimal individual and team performance
  • Monitors efficacy of American Kidney Fund Health Insurance Premium Program and Indigent Waiver processing to ensure program goals are met
• Identifies avoidable commercial losses and quickly intervenes with guidance and coaching to affect a positive resolution for our patients and company.
• Develops strong working relationships with Reimbursement Management, Managed Care, Business Development, Directors of Operations, Regional Vice Presidents, Group Vice Presidents, and General Managers to facilitate effective execution of goals of the program.
• Supports the Insurance Coordinator Supervisor in advocating on behalf of patients as needed with local Social Security Administration offices and other necessary entities, State Departments of Insurance, State Departments of Labor, and to ensure timely processing of Medicare, Medicaid, and COBRA applications and reinstatements
• Review and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations.
• Ensure all employees within the assigned team(s) understand and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations; establishing and maintaining effective internal systems and controls to promote compliance.
• Assist with various projects as assigned.
• 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.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians. 
• The position requires travel between assigned facilities and various locations within the assigned Region. Travel to regional, Division and Corporate meetings may be required.

EDUCATION:

• Bachelor's degree is required.

EXPERIENCE AND REQUIRED SKILLS:

• 6-8 years of directly related customer/patient service management experience, preferably in a healthcare environment, finance or accounting.
• At least 2-3 years of experience in a Supervisor role
• Demonstrated management and leadership competencies and skills
• Excellent communication skills - written and oral - with ability to communicate to all levels of company staff as well as external customers (i.e., patients, physician practices, state and federal departments and agencies, etc.¦)
• Excellent skills in customer service, continuous quality improvement, relationship development, team building, motivating employees, and decision-making
• Results-driven
• Demonstrated skills in diversity management and performance management
• Detail oriented
• Good computer skills - proficient in Excel, Microsoft Word, and PowerPoint

EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity

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