Member Enrollment Coordinator

Fresenius Medical Care Health Plan (?FMCHP?) a division of Fresenius Medical Care North America (FMCNA) is a special needs health plan offering health insurance coverage for Medicare beneficiaries with end stage renal disease. FMCHP is based in Lexington MA with current operations in Texas, Massachusetts and Pennsylvania and expanding into southern California, northern Alabama and central Tennesse.

 

This is an excellent opportunity for a licensed Life and Health Insurance agent to work from their home office located in either the Philadelphia or Pittsburgh area.  This position is responsible for the enrollment and retention of Fresenius Medical Care Health Plan (FMCHP) prospective and current members, within the Fresenius Medical Care Disease Management department. The scope of this function includes development of provider services support to include member enrollment and status verification with FMCHP insurance company partners and inter-company notifications. 

 

Principle Responsibilities:

?  Conduct Open Enrollment events for the introduction and education of prospective plan members, in FMCNA dialysis clinics and other appropriate locations.

?  Provide telephonic product education and enrollment applications.

?  Provide ongoing management of member enrollment inquires and application processing.

?  Provide ongoing management of enrolled member status, to include periodic (no less than monthly) enrollment updates with FMCHP insurance partners.
Provide ongoing management of FMCHP vendor notification based upon enrolled member status.

?  Develop process for and provide for ongoing management of FMCHP enrolled member Medicare secondary insurance coverage surveillance.

?  Will maintain region based contracted provider files and monitor for compliance with contract standards and recredentialing as required by contracts.

?  Other duties as assigned.

 

Education:

Required: Undergraduate degree in business administration or accounting and/or equivalent work experience with a health insurance company, health maintenance organization or disease management company.

 Experience and Required Skills:

?  State of Pennsylvania Life and Health Insurance Licensed Agent, multi-state license desired

?  Health and/or life insurance sales experience and application intake. 

?  Ability to work independently without day-to-day supervision.

?  Experience with large databases, including knowledge of Excel.

?  Excellent verbal and written communication skills required for interacting with physicians, nurses, management personnel, and peers.

?  Knowledge of insurance industry provider relations and the dialysis industry preferred. 

?  Experience with financial modeling and/or data mining.

 

For more information please visit our website at www.fmcna.com