Healthcare Intake & Insurance Verification Manager

Company:              The Breastfeeding Shop, Emmaus, PA

Industry:                Healthcare / Durable Medical Equipment (DME)

Reports To:           CEO

Position Overview:  The Breastfeeding Shop is seeking an experienced Healthcare Intake & Insurance Verification Manager to lead our Order Intake and Insurance Verification team.

This position requires an individual who fundamentally understands health insurance and is comfortable navigating complex eligibility and benefit situations. This individual will serve as the team's primary resource for resolving difficult insurance questions, while also managing the team's daily workflow, productivity, accuracy, and performance.

While the primary responsibility is leading the department, this person must understand the work well enough to jump in and process orders when volume is high or the department is short-staffed.

This position requires someone who can successfully manage both people and processes.
The Healthcare Intake & Insurance Verification Manager will be responsible for keeping the department organized, productive, and accountable while ensuring employees have the support they need to succeed.

Key Responsibilities

• Manage the day-to-day operations of the Order Intake and Insurance Verification team.
• Understand and interpret health insurance eligibility and benefit information.
• Identify primary and secondary insurance coverage and understand coordination of benefits.
• Serve as the go-to resource for complex insurance and eligibility issues that processors cannot independently resolve.
• Research difficult cases, troubleshoot problems, and provide employees with clear direction on how to move orders forward.
• Develop the team's insurance knowledge and help processors become stronger at independently resolving issues.
• Monitor order queues, outstanding work, aging orders, and backlogs.
• Identify orders that are stuck or delayed and determine what is preventing them from moving forward.
• Jump in and personally process orders when necessary due to vacations and/or increased volume, or operational needs.
• Manage and balance employee workloads to ensure orders are processed efficiently.
• Establish and monitor KPIs and productivity metrics for the Intake team.
• Track orders processed per employee, turnaround times, accuracy, backlogs, and other key performance indicators.
• Regularly review employee performance and hold team members accountable to established expectations.
• Coach and train employees when productivity or quality standards are not being met.
• Identify recurring workflow problems and recommend solutions.
• Communicate significant operational, staffing, or insurance-related issues to executive leadership.

Qualifications

• Strong understanding of health insurance is required.
• Experience with insurance eligibility and benefit verification.
• Strong understanding of primary and secondary insurance and coordination of benefits.
• Experience resolving complex health insurance or eligibility issues.
• 3-5 years of previous management or supervisory experience.
• Experience managing employee productivity, workloads, and KPIs.
• Ability to coach employees and hold team members accountable.
• Strong analytical and problem-solving skills.
• Ability and willingness to perform hands-on order processing when needed.
• Strong organizational skills and attention to detail.
• Comfortable working in a fast-paced, high-volume healthcare environment.
• Strong written and verbal communication skills.
• Experience with Salesforce and Microsoft Office Suite a plus.
• Previous DME or breast pump experience is a plus.

We are looking for someone who is knowledgeable, proactive, organized, accountable, and comfortable taking ownership.

This is an excellent opportunity for an experienced healthcare insurance professional who is ready to combine their insurance expertise with leadership and operational management in a growing healthcare organization.

The Breastfeeding Shop is for mothers who need proper help, guidance, and accessories to help them with nursing their babies, The Breastfeeding Shop brings the best of all. We are a family-owned business and because we understand the joys and challenges of being a new mom, we have brought together a range of supplies for all mothers who choose to breastfeed or those who need access to a breast pump. www.thebreastfeedingshop.com

                      The Breastfeeding Shop is an equal-opportunity employer.