Authorization Specialist - Start Day 1 Benefits

KabaFusion; Edison (NJ); Vor Ort; USD 30.000 - 39.000; Vollzeit

Benefits dieser Stelle

Competitive compensation

401k with match – no waiting

PTO / Floating Holidays / Holidays

Company paid life insurance

Employee assistance programs

Learning & Development

Perks include discounts

Zusammenfassung

KabaFusion is seeking an Authorization Representative to verify insurance coverage, obtain authorizations, and complete start-of-care documentation to ensure uninterrupted patient care. You will collaborate with patients, payors, and internal teams to protect revenue integrity and compliance.

Responsibilities include verifying benefits, documenting eligibility, and communicating authorization timelines and requirements to clinical and billing staff, while maintaining HIPAA compliance and a

Qualifikationen

• Experience with HCPCS/CPT codes, authorization submission processes, and insurance coverage requirements.
• Familiarity with Medicare, Medicaid and commercial plans and related billing methodologies.
• Strong problem-solving skills and ability to work with cross-functional teams.

Aufgaben

• Provides courteous and professional telephone support to patients, families, referral sources, payors, and clinical staff.
• Verifies insurance coverage prior to deliveries and notifies internal departments and patients of policy changes.
• Ensures services are eligible and covered under patient insurance benefits.
• Completes start‑of‑care, Financial Obligation, and Medicare/Medicaid forms accurately and distributes promptly.
• Collects and documents insurance cost-share and authorization details (coinsurance, copays, deductibles).
• Tracks authorization needs and secures ongoing authorizations to prevent missed care.
• Notifies stakeholders about approvals, issues, or delays in care.
• Estimates patient financial responsibility using verification data and payer contracts.
• Coordinates start‑of‑care materials and supports compliant service delivery.
• Documents eligibility, authorization, and communications in EMR.
• Assists with resolving insurance claim rejections to support timely reimbursement.
• Ensures HIPAA compliance and protects patient information.
• Performs additional duties as assigned by management.

Kenntnisse

HCPCS/CPT codes

Authorization submissions

Insurance coverage requirements

Medicare/Medicaid knowledge

Billing pricing methodologies

Ausbildung

High school diploma or equivalent

Tools

Microsoft Office

Electronic health record software

Jobbeschreibung

KabaFusion is seeking an Authorization Representative to verify insurance coverage, obtain authorizations, and complete start-of-care documentation to ensure uninterrupted patient care. You will collaborate with patients, payors, and internal teams to protect revenue integrity and compliance.

Responsibilities include verifying benefits, documenting eligibility, and communicating authorization timelines and requirements to clinical and billing staff, while maintaining HIPAA compliance and a