Insurance Case Manager - IV

About Us

Palmetto Infusion provides comprehensive ambulatory and home-based infusion services to both acute and chronically ill patients. Our centers care for people by providing patients and their families with a convenient, affordable, and safe place to receive infusion treatments. We strive for more than personal service – always delivering a warm and attentive health‑care experience that boosts patients’ state‑of‑mind, improves their health, and quality of life.

At Palmetto Infusion, we believe in creating an experience that goes beyond just a job. It’s about being part of something bigger than yourself – a connected group of caretakers who work together to restore health and hope to our patients. We call it The Palmetto Experience, and we believe it’s what sets us apart from other employers.

For our employees, The Palmetto Experience means we serve and support people in our purpose to restore health and hope, we build a culture of belonging and collaboration, we deliver on our promise to treat people with respect and empathy, and we strive to embrace change and search for new opportunities.

The Insurance Case Manager functions as an integral member of a multidisciplinary clinical team which manages the care of patients. The Insurance Case Manager will verify patient’s health benefits and coverage for infusion services, work closely with the Intake Coordinator to process new referrals in a timely manner, ensure accurate and complete verification of insurance benefits, and collaborate with the Nurse Manager and Reimbursement team to provide and promote customer service, process flow, operational integrity, quality care, and process improvement while upholding high service standards.

Schedule:

Monday – Friday; 8:00 AM – 5:00 PM.

• High School Diploma or Equivalent.
• 2 years of experience managing insurance benefit verifications and authorizations.
• Proficient with partner programs (i.e., MS Outlook, Word, Excel).
• Ability to cope with an ambiguous, changing environment while under pressure in a calm manner.
• Must be able to work as a team member and develop productive and cooperative working relationships with all members of the Palmetto Infusion team.

• Obtains patient data from referring physician office to support medical necessity; ensures data integrity.
• Verifies insurance using both website and phone verifications.
• Completes the insurance verification form and ensures proper documentation is scanned into the patient medical record.
• Reviews payer medical policy to determine medical necessity based on payer guidelines and/or FDA indications.
• Utilizes insurance payer policies and requirements to determine coverage.
• Provides a comprehensive coverage and benefit summary, documentation, and ongoing communication for updates, changes and authorizations.
• Manages an ongoing caseload of patients on long‑term therapies, including reauthorization as applicable.
• Coordinates first payment and payment plans when necessary.
• Obtains signed written orders (SWO) and letters of medical necessity (LMN) when required.
• Demonstrates ability to maintain calm under pressure.
• Acts as a primary point of contact on‑call for after‑hours and holidays as needed.

• Competitive Compensation
• Comprehensive Medical Insurance
• Dental and Vision Insurance
• Company Life Insurance
• Voluntary Life and Disability Insurance
• Additional Voluntary Supplemental Plans
• Flexible Spending Account (Medical and Dependent Care)
• Health Savings Account
• 401(k) Retirement Plan
• Employee Assistance Program (EAP)
• Employee Discounts
• Ramsey Smart Dollar Program
• Referral Program
• Tuition Assistance
• Paid Time Off
• 8 Paid Company Holidays

At Palmetto Infusion, we believe that patient advocacy is at the heart of everything we do, regardless of our roles within the organization. Each member of our team is dedicated to putting the needs and well‑being of our patients first. Whether we’re working directly with patients or supporting them behind the scenes, our commitment to being a compassionate advocate is paramount.

We understand that every interaction, every decision, and every effort contributes to the quality…