2. Verifies insurance coverage prior to deliveries to ensure accuracy, active coverage and notifies internal departments and patients of any policy changes or benefit terminations.
3. Ensures services to be provided are eligible and covered under the patient’s insurance benefits.
4. 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.
5. Collects, verifies, and documents insurance cost‑share and authorization details, including coinsurance, copays, deductibles, and requirements.
6. Tracks authorization needs and expirations and secures authorization for ongoing patient care to prevent missed administration of medication.
7. Provides timely notification to internal stakeholders, prescribers, and patients regarding authorization approvals, issues, or delays in care.
8. Accurately estimates patient financial responsibility by applying insurance verification information, payer contracts, and self‑pay policies.
9. Coordinates and documents patient start‑of‑care materials, creating additional documentation on a timely basis as needed to support compliant service delivery.
10. Ensures complete and accurate documentation of eligibility, authorization, and communications within the electronic medical record.
11. Assists with analyzing and resolving insurance claim rejections to support timely and accurate reimbursement.
12. Protects patient health information by following regulations for HIPAA compliance
13. Other related duties as assigned by manager or designee.
JOB REQUIREMENTS AND QUALIFICATIONS
Education
High school diploma or equivalent education.
Experience
Minimum of two (2) years in home infusion or fast-paced health care environment
Experience with …
Proficient experience with Microsoft Office including Word, Excel, and Teams, and/or electronic health care record software system preferred.
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.