Insurance Specialist 2 30p 11 00p - (Franklin) in Nashville, Tennessee For Sale

PURPOSE AND SCOPE: Supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMCNA policy requirements. Reviews, verifies, and processes orders in the pharmacy management system's work queue. Serves as a resource to patients, dialysis facility personnel, and other Fresenius Medical Care employees for insurance coverage and pharmacy benefit related issues. DUTIES / ACTIVITIES: CUSTOMER SERVICE: Responsible for driving the FMCNA culture through values and customer service standards. Accountable for outstanding customer service to all external and internal customers. Develops and maintains effective relationships through effective and timely communication. Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner. PRINCIPAL RESPONSIBILITIES AND DUTIES Verifies insurance coverage by phone, online or through E1 (electronic system) transactions for all new patients and/or changes in coverage. Contacts all new patients (via telephone) to verify the amount(s) that will be paid out-of-pocket/co-pays. Maintains confidentiality of information at all times. Assists patients with understanding their pharmacy benefits and available resources. Educates patients regarding availability of alternative insurance options, such as providing Medicare part D assistance and education. Assists when insurance coverage changes between companies or to Medicare, and/or refers patients to a social worker. Answers patients' questions regarding insurance coverage. Refers escalated questions/situations to supervisor or appropriate department (such as Billing to address a Billing error), or if a patient wants to opt out of the program. Enters patient insurance information under the patient's account in the pharmacy data system. Reviews all enrollment forms. Ensures insurance information and appropriate referrals have been completely and accurately obtained. May be required to follow up with social worker, insurance company, and/or patient to complete the application and verify insurance. Demonstrates knowledge and understanding of insurance billing requirements. Monitors all patients' insurance information to ensure that it is updated and accurate. Addresses any identified anomalies or discrepancies, researches and answers questions as needed. Analyzes patient reports from pharmacy data system as an audit check to ensure the correct insurance information is entered and that other changes are not overlooked. Researches and corrects any discrepancies identified. Prepares monthly reports to track work progress. Completes work within authorized time to assure compliance with departmental standards. Other duties as assigned 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. EDUCATION High School Diploma required. Prior courses in insurance billing and data processing preferred. Health Insurance Certification preferred. EXPERIENCE AND REQUIRED SKILLS A minimum of 1-2 years of experience in a customer service role required. Excellent customer service, communication, organizational and interpersonal skills required Understands the importance of, and demonstrates a customer service philosophy Excellent written and verbal communication skills Excellent organizational and analytical skills Detail oriented with the ability to enter information accurately on paper and into a database system Computer Skills Develops a working knowledge of pharmacy dispensing regulations, pharmacy data systems, and pharmacy billing practices and policies Develops a working knowledge of standard medical abbreviations and medical terminology EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity Company Description: Fresenius Medical Care North America (FMCNA) is proud that our unwavering commitment to our patients has made us the global leader in dialysis healthcare. Our caring professionals touch the lives of over 160,000 patients and their families, combining innovative care with profound personal connections. We're the largest provider of renal care products and services in the nation, including state-of-the-art dialysis machines, dialyzers and pharmaceuticals. We're also home to the country's largest renal specialty laboratories. Every day, our professionals collaborate, challenge one another and ultimately make groundbreaking discoveries that change patients' lives for the better. FMCNA's dialysis care services include hemodialysis, home dialysis and transplant support services, and in-center services to provide our patients with unsurpassed personalized care. Join us and we'll connect you to a career and a community that reward you in every way.
Source: http://www.juju.com/jad/xxxxxxxxlbk1gz?partnerid=af0exxxx314cbc501beebacaxxxx739d&exported=True&channel=staticfile&hosted_timestamp=xxxxa345f27ac5dcxxxxdac1d5f7dc37abd9bexxxx92f83d4e4f575cab33b130