Health Insurance Specialist - Patient Educator (Hybrid)

Insurance Specialist / Patient Insurance Educator

Position Type & Travel: Hybrid Role - Work from Home & Travel to Dialysis Clinics in Assigned Region

Summary:

Innovative Renal Care is seeking a detail-oriented Insurance Specialist to help patients navigate their health insurance options. In this role, you will educate patients about eligibility requirements, their insurance options, help guide them through the enrollment process for Qualified Health Plans (QHPs) via Federal and State Exchanges, and support access to insurance affordability programs.

As an Insurance Specialist, you will play a vital role in helping dialysis patients understand and navigate their insurance options. This hybrid position allows you to work from home while also visiting assigned clinics within your region to meet regularly with patients, provide education, and coordinate insurance solutions tailored to their needs.

Essential Functions:

• Ensure compliance with federal regulations, CMS guidelines, and internal policies.
• Educate patients on available Qualified Health Plan (QHP) options and insurance affordability programs, providing clear, accurate, and impartial information.
• Assist patients with completing and submitting eligibility applications for health coverage.
• Guide individuals with disabilities through the enrollment process directly or via appropriate referrals (Navigators, non-Navigator personnel, or Exchange Call Centers).
• Maintain strict confidentiality of patient information, adhering to HIPAA and other applicable regulations.
• Process and maintain required documentation in accordance with regulatory standards.
• Communicate effectively, both verbally and in writing, with empathy and sensitivity.
• Use independent judgment to address patient needs in a dynamic healthcare environment.

Required Education and Experience:

• Bachelor's degree in a healthcare-related field preferred; a combination of education and experience will be considered.
• Experience with eligibility and enrollment rules and procedures, Qualified Health Plan (QHP) options, insurance affordability programs, and an understanding of the needs of underserved and vulnerable populations.
• 1-3 years of experience in a related field preferred - health insurance, patient advocacy.
• Knowledge of privacy and security standards, including HIPAA compliance.
• Proficiency in Microsoft Office applications (Excel, Word, Outlook, PowerPoint).
• Must be able to travel to clinics up to 50% of the time.
• Completion of an Insurance Specialist training program; may be required to complete federal and state Certified Application Counselor training and certification, along with any additional mandated training. Must comply with annual training and recertification requirements.

About Innovative Renal Care:
At Innovative Renal Care (IRC), we are one of the largest dialysis service providers in the U.S., partnering with local physicians to deliver high-quality care to patients with ESRD and other kidney conditions. Our mission is to be the trusted experts and preferred partners for patients, physicians, and healthcare providers by delivering best-in-class care, service, and solutions.

Our values, summarized as I CARE, guide everything we do:

• Integrity & Innovation: Earn trust by delivering on promises and finding new ways to solve problems.
• Compassion: Treat patients, their families, and colleagues with respect and empathy.
• Accountability: Take responsibility and show appreciation for others.
• Results Driven: Strive to exceed expectations and achieve excellence.
• Everyone Counts: Foster diversity, equity, teamwork, and collaboration.

Equal Opportunity Employer:

Innovative Renal Care is an equal opportunity employer and a drug free workplace. All qualified We applicants will receive consideration for employment without regards to race, color, religion, sex, sexual orientation, gender identity, national origin, citizenship, disability, or protected veteran status.

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