Healthcare Insurance Authorization Specialist

KabaFusion; Chicago (IL); On-site; USD 36,000 - 41,000; Full time

Benefits offered by this job

Competitive compensation

Benefits start day 1

401k match

Paid time off

Life insurance

Short-term disability

Employee Assistance programs

Learning & Development

Discount programs

Job summary

KabaFusion is hiring an Authorization Representative in Chicago, IL to secure accurate insurance verification, required authorizations, and complete start-of-care documentation. You will protect revenue integrity, support clean claims, and coordinate with patients, payers, and internal teams to align with our mission and goals.

The role requires at least two years in home infusion or fast-paced healthcare, strong knowledge of insurance processes, and proficiency with Microsoft Office and EHR

Qualifications

• High school diploma or equivalent.
• Minimum of two years in home infusion or fast-paced health care environment.
• Experience with Microsoft Office including Word, Excel, and Teams, and/or electronic health care record software system preferred.
• 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.

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.

Skills

Insurance verification

Authorization submission

HCPCS/CPT codes

Pricing calculations

Microsoft Office

Communication

Independent work

Cross-functional collaboration

Education

High school diploma or equivalent

Tools

Microsoft Office

EHR software

Job description

KabaFusion is hiring an Authorization Representative in Chicago, IL to secure accurate insurance verification, required authorizations, and complete start-of-care documentation. You will protect revenue integrity, support clean claims, and coordinate with patients, payers, and internal teams to align with our mission and goals.

The role requires at least two years in home infusion or fast-paced healthcare, strong knowledge of insurance processes, and proficiency with Microsoft Office and EHR