INSURANCE SPECIALIST II

Job Description

Job Description

Patient Care America is a premier renal healthcare provider specializing in precision medicine, nutrition support, and clinical solutions for kidney disease patients. We offer evidence-based therapies such as IDPN (Intradialytic Parenteral Nutrition) and IPN (Intraperitoneal Nutrition) to help manage malnutrition and improve clinical outcomes. Backed by published research demonstrating improvements in albumin levels, our therapies are trusted by nephrology teams and dialysis clinics nationwide.

Proudly accredited by PCAB, ACHC, and NABP, we uphold the highest standards of safety, quality, and care. But our commitment extends far beyond delivering infusion therapies; our value-added services include oral nutrition supplement programs, access to our clinical support nurse team, patient support networks, and free continuing education for registered dietitians and nurses.

As a leading renal solutions provider, we also offer bundled prescription medications, streamlining delivery and supporting improved medication adherence.

To support patients beyond the clinic, we provide digital tools and community-based platforms tailored to their needs and experiences. These tools include educational resources, the TransplantLyfe365 app, and an online peer community (www.TransplantLyfe.com) that helps patients connect with others and manage the everyday challenges of chronic kidney disease and transplantation.

Driven by a dedicated commitment to scientific rigor, clinical excellence, and compassionate care, Patient Care America is redefining what it means to be a true partner through each stage of kidney care.

BENEFITS

Our company offers :

• Competitive pay
• Monthly bonus program
• Generous paid time off
• Paid holidays
• Health insurance
• Life insurance
• Employer-paid Long-term and Short-term Disability
• Wellness
• 401 (k) retirement with company matching program
• Educational assistance
• Career growth
• and much, much more!!

You must be able to pass a drug, background screen, and be eligible to work in the U.S.

JOB SUMMARY :

The Insurance Specialist II is a member of the insurance team, responsible for managing complex insurance verification, prior authorizations, and appeals. This role involves working with a wide range of insurance plans, including major medical, PBM, Medicare B & D, and IPA claims. Specialist II provides guidance to Tier I staff, resolves escalated cases, ensures accurate billing and reimbursement, and collaborates with patients, healthcare providers, and payers to guarantee timely access to care.

QUALIFICATIONS :

ESSENTIAL DUTIES AND RESPONSIBILITIES :