Operations Specialist
AdaptHealth
full-time
Posted on:
Location Type: Remote
Location: United States
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About the role
- 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.
- 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.
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.
- General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred.
Benefits
- None specified 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
data analysisinsurance verificationEMR systemsdocumentation processingworkflow improvementclaims managementbillingpre-authorizationpatient eligibility determinationquality assurance
Soft Skills
attention to detailorganizational skillsactive listeningcompassionempathytroubleshootingcollaborationcommunicationproblem-solvingtraining development
Certifications
High School Diplomacompliance training