Operations Specialist

Job Description

Job Description

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 :

Requirements :

Education and Experience Requirements :

Physical Demands and Work Environment :

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