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Operations Specialist

Operations Specialist

AdaptHealth LLCChattanooga, Tennessee, US
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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.
  • PI48c9f7a3de2b-29400-38061258

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