Quality Assurance Referral Coordinator

KabaFusion•Edison, NJ

About The Position

As a Quality Assurance Referral Coordinator with KabaFusion, you serve as liaison between the Sales team and Intake, reducing the amount of the Sales team’s extensive paperwork once a relationship is established. This role focuses on administrative tasks and incorporates quality assurance responsibilities. By incorporating QA responsibilities, this role streamlines and enhances the efficiency of insurance authorizations, while upholding high-quality standards and ensuring regulatory compliance.

Requirements

Extensive knowledge of insurance carrier procedures
Knowledge of and an analytical understanding of EDI, ERA, EFT’s
2+ years of medical billing or rev cycle experience (payments & claims)

Responsibilities

Advocates on behalf of patients and healthcare providers to insurance companies, ensuring necessary medications are approved in a timely manner while ensuring services meet quality standards and patient needs.
Maintains accurate and detailed records of authorization requests, approvals, denials, and communications related to insurance authorizations for reference and reporting purposes, ensuring compliance with documentation and record-keeping standards for quality assurance
Provides support and guidance to sales representatives regarding insurance authorization processes, ensures understanding of requirements and can navigate challenges encountered.