Estimation Specialist

Description

Estimations Specialist 

Key Responsibilities: 

• Cost Estimation & Analysis: (TOS Pre-Service) 
• Responsible for monitoring the patient cases assigned for an estimate request along with monitoring the appointment report for missed cases.  
• 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) 
• 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 through the delivery of estimate paperwork via the necessary tools within the EMR or other Estimations tools and Software (i.e. Rivet) 
• Pre-Visit Collections 
• Collect payments of all pre-surgery deposits and full estimates ahead of their scheduled procedure at CSC, Hospital; notify clinics of any unpaid amounts that would be collected at the time of service. 
• Collect payments of all estimates provided to patients prior to scheduled services at AU clinics; notify clinics of any unpaid amounts that would be collected at the time of service.  
• Collect any outstanding balances as required per AU’s Collections policy 
• Pre-Visit Analysis 
• Review upcoming appointment reports for outstanding balances through a Pre-Financial Balance report 
• Discuss payment options to resolve outstanding balances 
• Collaborative Support: (TOS Pre-Service) 
• Work closely with the billing, insurance, and financial assistance 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: (TOS Pre-Service) 
• 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. 
• Technology Use 
• Utilize 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: 

• Minimum of 2 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.