Infusion Case Manager: Patient Access & Insurance Support

Palmetto Infusion; Eastman (GA); Hybrid; USD 52,000 - 68,000; Full time

Benefits offered by this job

Dental & Vision Insurance

Life Insurance

Tuition Assistance

Paid Time Off

8 Paid Company Holidays

401K Retirement Plan

Employee Assistance Program

Referral Program

Job summary

Palmetto Infusion seeks a Case Manager to onboard new patient referrals and manage cases through scheduling. You will gather information from MD offices, verify insurance benefits, and review clinical necessity for infusion services, documenting rationale in the EMR. Workweek is Monday–Friday, 8:00 AM–5:00 PM.

The role emphasizes customer service, collaboration with the Palmetto Infusion team, and process improvement to uphold high service standards and patient care excellence.

Qualifications

• Requires high school diploma or equivalent.
• 1 year healthcare or customer service experience.
• Proficient with MS Outlook, Word, Excel.
• Ability to adapt to a changing environment under pressure in a calm manner.
• Ability to work as part of Palmetto Infusion team.

Responsibilities

• Provides timely acceptance and completion of new referral including insurance verification, authorization, and Predeterminations as needed.
• Obtains all needed information from MD office for insurance authorizations and clinical purposes.
• Obtains patient data from referring physician office for support of medical necessity by reviewing payor policies and/or FDA guidelines providing the initial clinical review; Documents in the EMR system the clinical rationale supporting the approval or denial of an infusion service based on the payer policy or FDA guidelines.
• Communicates with peers, supervisors, and other PI team members in a non‑threatening manner maintaining a courteous demeanor at all times.
• Take initiative to present ideas and suggestions for process improvements to the team lead, supervisors, and management. Maintain knowledge and proficiency in medical practices through continuing education, staff meetings, and workshops.
• Supports the marketing efforts of PI by assisting the sales team and providing education materials to the referral sources as requested.

Skills

Team collaboration

Communication under pressure

Customer service

Education

High school diploma or equivalent

Tools

MS Outlook

MS Word

MS Excel

Job description

Palmetto Infusion seeks a Case Manager to onboard new patient referrals and manage cases through scheduling. You will gather information from MD offices, verify insurance benefits, and review clinical necessity for infusion services, documenting rationale in the EMR. Workweek is Monday–Friday, 8:00 AM–5:00 PM.

The role emphasizes customer service, collaboration with the Palmetto Infusion team, and process improvement to uphold high service standards and patient care excellence.