Estimation & Intake Manager

Description

Job Description: Estimations and Intake Manager 

Position Overview: 

We are seeking a dedicated and knowledgeable Estimations and Intake Manager to play a crucial role ensuring a smooth experience for patients. This individual will lead a team that assists patients with verifying benefits, obtaining prior authorizations, providing accurate cost estimates, answering billing inquiries, and offering comprehensive guidance on insurance coverage, payment options, and financial assistance programs. Your expertise will enhance our operational workflow, improve patient satisfaction, and support our financial health. The ideal candidate will have a strong understanding of healthcare billing systems, excellent communication skills, self-driven and has passion for delivering compassionate support to patients. 

Key Responsibilities: 

• Manage the Estimations, Intake and Prior-Authorization Team:  
• Supervise, train, and mentor a team of estimation specialists, ensuring they are equipped with the necessary knowledge and tools to perform their duties effectively.  
• Cost Estimation & Analysis: 
• Provide accurate, timely, and comprehensive cost estimates for patients based on their insurance coverage and the services they will receive. (i.e. In-Office Procedures such as cancer injections, medications, radiology, office procedures, CSC, and Hospital Surgeries) 
• Work closely with clinical teams and billing departments to ensure estimates are precise and align with the patient’s care plan. 
• Ensure that patients are informed of potential out-of-pocket costs and payment expectations. 
• Collaborative Support: 
• Work closely with the billing and insurance departments to ensure seamless service for patients.  
• Collaborate with other team members and clinical teams to ensure accurate data entry, processing of estimates, and resolution of any financial-related issues. 
• Patient Education: 
• Provide education to patients regarding their financial obligations and help them understand their rights and options. Offer reassurance and support to ease patient stress surrounding financial concerns. 
• Serve as a point of contact for clarifying cost estimations for patients, insurance companies, and external stakeholders, ensuring a clear understanding of financial responsibility. 
• Continuous Improvement: 
• Continuously assess and improve policies, identifying opportunities for increased accuracy and efficiency. Stay up to date on changes in healthcare regulations, insurance practices, and financial assistance policies. 
• Problem-Solving and Dispute Resolution:  
• Address discrepancies or disputes regarding procedure cost estimates between patients, insurance companies, or internal departments. Propose solutions to resolve issues in a timely and customer-friendly manner.  
• Technology Management 
• Utilize and manage healthcare software tools and systems (such as Electronic Health Records (EHR), billing systems, and estimating platforms) to automate and enhance the estimation process. 

Required Qualifications: 

• Bachelor’s degree in healthcare administration, business, or a related field (or equivalent experience). 
• Minimum of 3 years of experience in healthcare billing, financial services, or a similar role. 
• Strong knowledge of healthcare insurance plans, billing practices, and financial assistance programs. 
• Exceptional customer service skills with the ability to communicate complex financial information in a clear and compassionate manner. 
• Experience with healthcare software systems (e.g., EHR, patient billing systems) and Microsoft Office Suite. 
• Strong problem-solving abilities and attention to detail. 
• Ability to work in a fast-paced environment while maintaining a high level of accuracy. 

Preferred Qualifications: 

• Previous experience in a managerial or supervisory role. 
• Knowledge of government programs (Medicare, Medicaid) and private insurance plans. 

Personal Attributes: 

• Empathy and understanding of patients’ financial challenges. 
• Strong organizational skills and the ability to multitask effectively. 
• Proactive and solutions-oriented approach to problem-solving. 
• Ability to work well within a team and foster a positive, collaborative work environment. 

Work Environment: 

• Office-based position with the possibility of some remote work options. 
• Interaction with patients, healthcare providers, and insurance representatives regularly.