Customer Reimbursement Hotline Manager - Sight Sciences Inc

Overview: The Reimbursement Support Hotline Manager will oversee and manage a team responsible for providing expert assistance and guidance to customers regarding reimbursement processes and procedures. This role involves ensuring excellent customer service, maintaining compliance with relevant regulations, and continuously improving hotline operations. The ideal candidate will have strong leadership skills, a deep knowledge of reimbursement processes, and experience in managing customer support teams. This role is crucial in ensuring that providers receive accurate and timely assistance with their reimbursement claims, contributing to customer satisfaction and operational efficiencies.
 

Responsibilities: 

• Lead, coach, and develop a team of reimbursement support specialists
• Conduct regular team meetings, performance reviews, and training sessions
• Foster a positive and collaborative team environment
• Step in and support overflow or provide team assistance as needed
• Ensure the team provides accurate and timely responses to customer inquiries regarding insurance verifications, reimbursement policies, claims, and procedures
• Handle escalated customer issues and resolve them efficiently
• Monitor and analyze customer feedback to identify areas for improvement
• Collaborate closely with directors and field managers to ensure customer feedback is incorporated into the program
• Develop and implement standard operating procedures for the hotline
• Monitor call center metrics (e.g., call volume, response times, resolution rates) to ensure high performance
• Collaborate with other departments to streamline processes and improve customer experience
• Create and maintain updated authorization tools
• Maintain a repository of payer-specific coverage information
• Ensure the team adheres to all relevant regulations, policies, and procedures
• Conduct regular audits to maintain high standards of service quality and compliance
• Stay updated on changes in reimbursement policies and ensure the team is informed and trained accordingly
• Prepare and present regular reports on hotline performance and customer satisfaction
• Analyze data to identify trends, areas for improvement, and opportunities for training

Skills/Qualifications: 

• Bachelor’s degree in Business, Healthcare Administration, a related field, or an equivalent experience required
• Minimum of 6 years of experience in customer support or call center management within the healthcare or insurance industry
• Ability to communicate clearly and effectively with customers
• Strong problem-solving skills to address customer issues and provide solutions
• Excellent leadership and team management skills
• Strong problem-solving abilities and attention to detail
• Exceptional communication and interpersonal skills
• Patience and empathy to handle sensitive situations with professionalism
• Knowledge of the steps involved in processing reimbursement claims
• Familiarity with relevant regulations and policies governing reimbursements
• Ability to review and verify claim documentation for accuracy and completeness
• Proficiency in using customer support software, reimbursement management systems, and office applications
• Ability to maintain detailed records and generate reports
• Skill in navigating and updating databases and other digital systems
• Reimbursement Support Coordinators must operate within a framework of strict regulatory requirements, including:
• Healthcare Regulations: must be familiar with regulations such as HIPAA (Health Insurance Portability and Accountability Act) in the United States, which governs the privacy and security of patient information
• Insurance Regulations: Knowledge of insurance policies and procedures is essential, including an understanding of different types of insurance plans and what they cover
• Compliance Standards: Adherence to company policies and industry standards to ensure that all claims are processed in a legally compliant manner
• Certification in customer service management or a related field preferred

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Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)