Operations Specialist Non-Driving

Description

Position Summary:

The Operations Specialist is a non-driving position responsible for supporting the Operations Team through multiple tasks required for the successful support of each region’s individual needs. The lead specialist serves as a subject matter expert, conducts new hire training and mentors the team.

• Supports operations team with discovery and training as necessary with Adapt Health 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 Adapt Health 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 handles 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.
• Must be able to navigate through multiple online EMR systems to obtain applicable documentation.
• Works with insurance verification team to ensure all needs are met for both teams to provide accurate information to the patient and ensure payments.
• Assume on‑call responsibilities during non‑business hours in accordance with company policy.
• Lead Responsibilities:
• Supervise and provide guidance to team members in daily operations and complex case resolution.
• Lead team meetings and facilitate training sessions for staff development.
• Monitor team performance metrics and productivity standards, providing feedback and coaching as needed.
• Serve as primary escalation point for difficult customer issues and complex regulatory compliance questions.
• Develop and implement process improvements and workflow optimization strategies.
• Coordinate with management on staffing needs, scheduling, and resource allocation.
• Conduct new employee onboarding and ongoing training programs.
• Maintain advanced expertise in Medicare guidelines, payer policies, and regulatory changes to guide team decisions.
• Prepare reports and analysis on team performance, trends, and operational metrics for management review.
• Maintains patient confidentiality and functions within the guidelines of HIPAA.
• Completes assigned compliance training and other education programs as required.
• Maintains compliance with Adapt Health's Compliance Program.
• Performs other related duties as assigned.

• Excellent ability to communicate both verbally and in writing.
• Ability to prioritize and manage multiple tasks.
• Profi…