Eligibility Specialist

Insurance Eligibility Specialist - Dialysis

Innovative Renal Care is seeking a detail-oriented Insurance Eligibility Specialist to support accurate insurance verification, benefit maintenance, and data integrity for our dialysis patients. This is a front-end revenue cycle role focused on real-time eligibility monitoring and clean account setup.

In this position, you will serve as a key connection between patients, clinic teams, and insurance payers. You will review and update coverage information, monitor payer portals for changes, and ensure patient accounts remain accurate and current to support uninterrupted access to dialysis care.

Key Responsibilities

• Perform ongoing insurance and benefit verifications utilizing payer portals to confirm coverage, network status, and plan requirements.
• Manage electronic work queues and Excel reports to identify insurance updates, plan changes, or retroactive terminations.
• Maintain accurate and timely patient insurance records within the billing system, initiating updates as coverage changes occur.
• Support complex insurance setups and Medicare Coordination of Benefits (COB) requirements in alignment with CMS guidelines.
• Partner with clinic staff, collections, and insurance education teams to communicate coverage updates and resolve active eligibility discrepancies.
• Monitor and process coverage changes that may require updates to authorization or referral tracking workflows.

Education & Experience

• Bachelor's degree in Business, Healthcare Administration, or a related field is preferred. An equivalent combination of education and significant relevant professional experience will be considered.
• Demonstrated experience in medical insurance verification, healthcare intake, patient registration, or pre-access portal auditing preferred.
• Proficiency navigating digital insurance portals, payer clearinghouses, and managing electronic data queues.
• Familiarity with Medicare COB rules, CPT/HCPCS terminology, or payer plan guidelines is highly preferred.
• Proficiency in Microsoft Office Suite, with a heavy emphasis on using Excel to navigate and organize clinic tracking reports.
• Exceptional written and verbal communication skills, including a proven track record of writing clean, explicit account documentation notes.

Benefits

At Innovative Renal Care (IRC), our comprehensive benefits program is a key component of our total compensation package. It includes a 401(k) match, healthcare coverage, and a broad range of other benefits that compare favorably within our industry and marketplace.

About Innovative Renal Care

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: I CARE

Integrity & Innovation – Earn trust by keeping promises and embracing new solutions.

Compassion – Treat patients, families, and colleagues with respect and empathy.

Accountability – Take ownership and recognize the contributions of others.

Results-Driven – Strive for excellence and exceed expectations.

Everyone Counts – Foster diversity, equity, teamwork, and collaboration.

Why Join IRC?

• Career Growth – Be part of a values-driven team making a meaningful impact.
• Competitive Compensation – Salaries continually benchmarked against market and trends.
• Enhanced PTO – Your most recent dialysis experience counts toward PTO accrual.
• Team Culture – Thrive in a supportive environment that values innovation, accountability, and compassion.

Innovative Renal Care is an equal opportunity and a drug free workplace. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, sexual orientation, gender identity, national origins, citizenship, disability or protected veteran status. All applicants will be subject to a drug screening and background check upon acceptance of an offer.

IRC will only contact you from View email address on click.appcast.io or team members with an @innovativerenal.com email address. Please be cautious and aware of spam or fraudulent emails soliciting personal or banking information. IRC will not request this information via email.

Salary Range: $18.00 - $22.00 / hour depending on experience and qualifications