Operations Specialist

Position Summary:

The Operations Specialist supports the Operations Team with multiple tasks required to meet each region’s needs.

Job Type: Full-time

Salary: $19-$23/hr DOE

• Supports operations team with discovery and training on Adapt Health processes.
• Provides support during process improvement initiatives, driving workflow, verification, and data analysis.
• Develops and maintains knowledge of current products and services offered by the company.
• Familiar with payer guidelines, reads clinical documentation to determine qualification status and compliance for all equipment and services.
• Maintains working knowledge of Adapt Health customer service, intake, daily operations and revenue cycle processes from beginning to end.
• Reviews all required documentation to ensure accuracy.
• Accurately processes, verifies, and/or submits documentation.
• Performs insurance verification to determine patient eligibility, coverage, co‑insurances, and deductibles.
• Obtains pre‑authorization when required by an insurance carrier and processes physician orders to insurers for approval and authorization when required.
• Navigates multiple online EMR systems to obtain applicable documentation.
• Enters and reviews all pertinent information in the EMR system, including authorizations and expiration dates.
• Meets quality assurance requirements and other key performance metrics.
• Pays attention to detail and demonstrates strong organizational skills.
• Actively listens to teams, region leaders and handles stressful situations with compassion and empathy.
• Analyzes data and reports to identify workflow errors, 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 trends in process errors with insurance companies.
• Assists with various projects and tasks as needed for unique processes.
• Participates in defining, documenting, and refining processes, procedures and workflows for business operations based on industry and company best‑practices.
• Participates in creating training materials and training 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 Adapt Health’s Compliance Program.
• Performs other related duties as assigned.

• Excellent verbal and written communication skills.
• Ability to prioritize and manage multiple tasks.
• Proficient computer skills and knowledge of Microsoft Office.
• Quick learner with the technical aptitude to understand data flow through systems.
• General knowledge of Medicare, Medicaid, and commercial health plan methodologies and documentation requirements preferred.
• Works well independently and as part of a group.
• Adaptable and flexible in a rapidly changing environment; patient, accountable, proactive, takes initiative, and works effectively on a team.

• High School Diploma or equivalency.
• Three (3) years of work experience in health‑care administrative, financial, or insurance customer services, claims, billing, call center, or management.

• Work environment will be stressful at times; office activities and workload fluctuate.
• Must be able to bend, stoop, stretch, stand, and sit for extended periods.
• Subject to long periods of sitting and exposure to a computer screen.
• Ability to perform repetitive wrist, hand, or finger motions due to extensive computer use.
• Excellent verbal and written communication skills.
• Ability to effectively communicate with internal and external customers, demonstrating empathy, compassion, courtesy, and respect for privacy.
• Mental alertness is required to perform essential functions of the position.

• Mid‑Senior level

• Full‑time

• Management and Manufacturing

• Hospitals and Health Care

Location:

Sacramento, CA