AdaptHealth
Position Summary
The Operations Specialist is responsible for supporting the Operations Team through multiple tasks required for the successful support of each region’s individual needs.
Essential Functions And Job Responsibilities
Supports operations team with discovery and training as necessary with AdaptHealth processes.
Provides support during process improvement initiatives to assist with driving all areas of workflow, including verification, and data analysis.
Develops and maintains a working knowledge of current products and services offered by the company.
Ensures familiarity with payer guidelines and reads clinical documentation to determine qualification status and compliance for all equipment and services.
Applies working knowledge in all areas of AdaptHealth customer service, intake, daily operations and revenue cycle processes and workflows from beginning to end.
Reviews all required documentation to ensure accuracy.
Accurately processes, verifies, and/or submits documentation.
Completes insurance verification to determine patient eligibility, coverage, co‑insurances, and deductibles.
Obtains pre‑authorization when required and processes physician orders to insurance carriers for approval and authorization when required.
Navigates through multiple online EMR systems to obtain applicable documentation.
Enters and reviews all pertinent information in EMR system, including authorizations and expiration dates.
Meets quality assurance requirements and other key performance metrics.
Pays attention to detail and has great organizational skills.
Actively listens to teams, region leaders and handles stressful situations with compassion and empathy.
Analyzes data and reports to identify execution errors in workflow, troubleshoots and fixes exceptions, and advises staff on corrections.
Collaborates with the Operations Team on exceptions and solutions within workflow processes.
Communicates with operations teams and leadership on an ongoing basis regarding any noticed trends in process errors with insurance companies.
Assists with various projects and tasks as needed for various unique processes.
Participates in the effort to define, document, and refine processes, procedures and workflows for business operations based on industry and company best‑practices.
Participates in the effort to create training materials and train client engagement and service teams.
Maintains patient confidentiality and functions within the guidelines of HIPAA.
Completes assigned compliance training and other educational programs as required.
Maintains compliance with AdaptHealth’s Compliance Program.
Performs other related duties as assigned.
Competency, Skills And Abilities
Excellent communication skills, both verbal and written.
Ability to prioritize and manage multiple tasks.
Proficient computer skills and knowledge of Microsoft Office.
Solid ability to learn new technologies and possess the technical aptitude required to understand the flow of data through systems as well as system interaction.
General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred.
Works well independently and as part of a group.
Adapts and is flexible in a rapidly changing environment, being patient, accountable, proactive, taking initiative and working effectively on a team.
Requirements
High school diploma or equivalency.
Three (3) years of work experience related to health care administration, financial or insurance customer services, claims, billing, call center, or management, regardless of industry.
Physical Demands And Work Environment
Work environment will be stressful at times, as overall office activities and work levels fluctuate.
Must be able to bend, stoop, stretch, stand, and sit for extended periods of time.
Subject to long periods of sitting and exposure to computer screens.
Requires repetitive motions of wrists, hands, and/or fingers due to extensive computer use.
Excellent communication skills, both verbal and written, with internal and external customers, demonstrating empathy, compassion, courtesy, and respect for privacy.
Mental alertness to perform the essential functions of the position.
Seniority level Mid-Senior level
Employment type Full‑time
Job function Management and Manufacturing
Industries Hospitals and Health Care
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Essential Functions And Job Responsibilities
Supports operations team with discovery and training as necessary with AdaptHealth processes.
Provides support during process improvement initiatives to assist with driving all areas of workflow, including verification, and data analysis.
Develops and maintains a working knowledge of current products and services offered by the company.
Ensures familiarity with payer guidelines and reads clinical documentation to determine qualification status and compliance for all equipment and services.
Applies working knowledge in all areas of AdaptHealth customer service, intake, daily operations and revenue cycle processes and workflows from beginning to end.
Reviews all required documentation to ensure accuracy.
Accurately processes, verifies, and/or submits documentation.
Completes insurance verification to determine patient eligibility, coverage, co‑insurances, and deductibles.
Obtains pre‑authorization when required and processes physician orders to insurance carriers for approval and authorization when required.
Navigates through multiple online EMR systems to obtain applicable documentation.
Enters and reviews all pertinent information in EMR system, including authorizations and expiration dates.
Meets quality assurance requirements and other key performance metrics.
Pays attention to detail and has great organizational skills.
Actively listens to teams, region leaders and handles stressful situations with compassion and empathy.
Analyzes data and reports to identify execution errors in workflow, troubleshoots and fixes exceptions, and advises staff on corrections.
Collaborates with the Operations Team on exceptions and solutions within workflow processes.
Communicates with operations teams and leadership on an ongoing basis regarding any noticed trends in process errors with insurance companies.
Assists with various projects and tasks as needed for various unique processes.
Participates in the effort to define, document, and refine processes, procedures and workflows for business operations based on industry and company best‑practices.
Participates in the effort to create training materials and train client engagement and service teams.
Maintains patient confidentiality and functions within the guidelines of HIPAA.
Completes assigned compliance training and other educational programs as required.
Maintains compliance with AdaptHealth’s Compliance Program.
Performs other related duties as assigned.
Competency, Skills And Abilities
Excellent communication skills, both verbal and written.
Ability to prioritize and manage multiple tasks.
Proficient computer skills and knowledge of Microsoft Office.
Solid ability to learn new technologies and possess the technical aptitude required to understand the flow of data through systems as well as system interaction.
General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred.
Works well independently and as part of a group.
Adapts and is flexible in a rapidly changing environment, being patient, accountable, proactive, taking initiative and working effectively on a team.
Requirements
High school diploma or equivalency.
Three (3) years of work experience related to health care administration, financial or insurance customer services, claims, billing, call center, or management, regardless of industry.
Physical Demands And Work Environment
Work environment will be stressful at times, as overall office activities and work levels fluctuate.
Must be able to bend, stoop, stretch, stand, and sit for extended periods of time.
Subject to long periods of sitting and exposure to computer screens.
Requires repetitive motions of wrists, hands, and/or fingers due to extensive computer use.
Excellent communication skills, both verbal and written, with internal and external customers, demonstrating empathy, compassion, courtesy, and respect for privacy.
Mental alertness to perform the essential functions of the position.
Seniority level Mid-Senior level
Employment type Full‑time
Job function Management and Manufacturing
Industries Hospitals and Health Care
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