Authorization Representative

KabaFusion; Carrollton (TX); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Competitive compensation

401k 4% match

PTO & Holidays

Life insurance

Short-term disability

Employee assistance program

Learning & development

Employee perks discounts

Referral program

Job summary

KabaFusion is a leading home infusion provider seeking an Insurance Verification Coordinator to ensure seamless patient care by securing verifications, authorizations, and start-of-care documentation.

You will collaborate with patients, payors, and clinical teams to protect revenue integrity, ensure eligibility, and support compliant service delivery. The role emphasizes accuracy and HIPAA compliance.

Qualifications

• High school diploma or equivalent.
• Minimum of two (2) years in home infusion or fast-paced health care environment.
• Knowledge of HCPCS/CPT codes, authorization submission processes, and insurance coverage requirements.

Responsibilities

• Provides courteous and professional telephone support to patients, families, referral sources, payors, and clinical staff.
• Verifies insurance coverage prior to deliveries to ensure accuracy, active coverage and notifies internal departments and patients of policy changes.
• Ensures services to be provided are eligible and covered under the patient's insurance benefits.
• Completes start-of-care, Financial Obligation, and Medicare/Medicaid forms and distributes to Pharmacy and Nursing Departments.
• Collects and documents insurance cost-share and authorization details (coinsurance, copays, deductibles).
• Tracks authorizations and secures ongoing patient care authorizations to prevent missed medication administration.
• Notifies stakeholders regarding authorization approvals, issues, or delays in care.
• Estimates patient financial responsibility using insurance verification, payer contracts, and self-pay policies.
• Documents start-of-care materials to support compliant service delivery.
• Ensures documentation of eligibility, authorization, and communications in EMR.
• Assists with analyzing and resolving insurance claim rejections to support timely reimbursement.
• Protects patient health information per HIPAA compliance.
• Other related duties as assigned by manager.

Skills

Phone support

Insurance verification

Authorization management

Billing systems

HIPAA compliance

Education

High school diploma

Job description

Come join an exciting and innovative company that puts the \"care\" back in healthcare!

About Us

What started as a single pharmacy in 2010 has grown into KabaFusion becoming the largest privately held home infusion company in the country. We have a national network of pharmacies and nursing offices strategically placed to service 40+ states. Couple that with over 30 years of combined experience and it's no wonder why KabaFusion is the industry leader in home infusion.

Job Summary

This position is responsible for ensuring patients continue care without delay by securing accurate insurance verification, required authorizations, and complete start-of-care documentation. This position protects revenue integrity, supports clean claims, and ensures compliance while coordinating effectively with patients, payers, and internal teams in alignment with the organization’s mission and operational goals.

Essential Duties And Responsibilities

• Provides courteous and professional telephone support to patients, families, referral sources, payors, and clinical staff.


• Verifies insurance coverage prior to deliveries to ensure accuracy, active coverage and notifies internal departments and patients of any policy changes or benefit terminations.


• Ensures services to be provided are eligible and covered under the patient's insurance benefits.


• Ensures accurate and timely completion of start-of-care, Financial Obligation, and Medicare/Medicaid forms and coordinates prompt distribution to the Pharmacy and Nursing Departments via electronic or postal delivery.


• Collects, verifies, and documents insurance cost-share and authorization details, including coinsurance, copays, deductibles, and requirements.


• Tracks authorization needs and expirations and secures authorization for ongoing patient care to prevent missed administration of medication.


• Provides timely notification to internal stakeholders, prescribers, and patients regarding authorization approvals, issues, or delays in care.


• Accurately estimates patient financial responsibility by applying insurance verification information, payer contracts, and self-pay policies.


• Coordinates and documents patient start-of-care materials, creating additional documentation on a timely basis as needed to support compliant service delivery.


• Ensures complete and accurate documentation of eligibility, authorization, and communications within the electronic medical record.


• Assists with analyzing and resolving insurance claim rejections to support timely and accurate reimbursement.


• Protects patient health information by following regulations for HIPAA compliance


• Other related duties as assigned by manager or designee.

Education

JOB REQUIREMENTS AND QUALIFICATIONS

• High school diploma or equivalent education.

Experience

• Minimum of two (2) years in home infusion or fast-paced health care environment

Experience with ...

Skills And Competencies

• Knowledge of HCPCS/CPT codes, authorization submission processes, and insurance coverage requirements, including Medicare, Medicaid, and commercial plans, with familiarity in medical terminology and billing pricing methodologies.


• Strong problem-solving skills with the ability to proactively research, analyze, and resolve issues independently, demonstrating initiative and sound judgment.


• Proficiency in learning and working with internal company platforms, including billing, authorization, and patient management systems.


• Ability to work independently with minimal supervision while effectively prioritizing, multitasking, and meeting goals and deadlines, as well as collaborating successfully with cross-functional teams.


• Demonstrated accuracy in calculating pricing quotes and authorization lengths using approved units and days, coupled with effective communication skills when interacting with patients, clinical teams, and corporate departments.

What We Offer

• Competitive compensation


• Benefits start on your 1st day of employment


• 401k w 4% match - no waiting or vesting period


• PTO / Floating Holidays / Paid Holidays


• Company paid life insurance, short term disability


• Employee Assistance programs to help with mental health / wellness


• Learning & Development Programs


• Perks... includes discounts on travel, cell phone, clothing and more...


• Generous employee referral program

To learn more about KabaFusion, please visit our careers page: https://www.kabafusion.com/careers/

Join us and find out why this is the place to excel and do your best work.