The Operations Specialist at AdaptHealth LLC supports the Operations Team by managing various tasks essential for regional workflow efficiency. This full-time role involves process improvement, documentation verification, and insurance eligibility assessments.
Job Type Full-time Description 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. • Responsible for providing support during process improvement initiatives to assist with driving all areas of workflow, including verification, and data analysis. • Develop and maintain working knowledge of current products and services offered by the company • Must be familiar with payer guidelines and reading clinical documentation to determine qualification status and compliance for all equipment and services. • Working knowledge in all areas of AdaptHealth customer service, intake, daily operations and revenue cycle processes and workflows from beginning to end, which may include • Review all required documentation to ensure accuracy • Accurately process, verify, and/or submit documentation • Complete insurance verification to determine patient's eligibility, coverage, co-insurances, and deductibles • Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required (if helping a region) • Navigate through multiple online EMR systems to obtain applicable documentation • Enter and review all pertinent information in EMR system including authorizations and expiration dates • Meet quality assurance requirements and other key performance metrics • Pays attention to detail and has great organizational skills • Actively listens to teams, region leaders and handle stressful situations with compassion and empathy. • Ability to analyze data and reports to identify execution errors in workflow, troubleshoot and fix the exceptions, advise staff on corrections. • Collaborate with the Operations Team on exceptions and solutions within workflow processes • Communicate with operations teams and leadership on an on-going basis regarding any noticed trends in process errors with insurance companies • Assist with various projects and tasks as needed for various unique processes • Participate in the effort to define, document, and refine processes, procedures and workflows for business operations based on industry and company best-practices. • Participate in the effort to create training materials and train client engagement and service teams • Maintain patient confidentiality and function within the guidelines of HIPAA. • Completes assigned compliance training and other educational programs as required. • Maintains compliant with AdaptHealth's Compliance Program. • Perform other related duties as assigned. Competency, Skills and Abilities: • Excellent ability to communicate both verbally and in writing • 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 flow of data through systems as well as system interaction • General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred. • Work well independently and as part of a group • Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative and work effectively on a team Requirements Education and Experience Requirements: • High School Diploma or equivalency • Three (3) years' work related in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry is required. 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 screen • Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use • Excellent ability to communicate both verbally and in writing • Ability to effectively communicate both verbally and written with internal and external customers with the ability to demonstrate empathy, compassion, courtesy, and respect for privacy. • Mental alertness to perform the essential functions of position. Salary Description $17-$21/hr DOE
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