Operations Specialist

Job Title & Company

Operations Specialist at Adapt Health

The Operations Specialist is responsible for supporting the Operations Team through multiple tasks required for the successful support of each region’s individual needs.

Full-time

• Supports operations team with discovery and training as necessary with Adapt Health processes.
• Provides support during process improvement initiatives to drive workflow, including verification and data analysis.
• Develops and maintains a working knowledge of current products and services offered by the company.
• Familiar with payer guidelines and reads clinical documentation to determine qualification status and compliance for all equipment and services.
• Has working knowledge of all areas of Adapt Health customer service, intake, daily operations and revenue cycle processes and workflows from beginning to end.
• Reviews all required documentation to ensure accuracy.
• Accurately processes, verifies, and/or submits documentation.
• Completes insurance verification to determine patient eligibility, coverage, co‑insurances, and deductibles.
• Obtains pre‑authorization if required by an insurance carrier and processes physician orders to insurance carriers for approval and authorization when required.
• Navigates multiple online EMR systems to obtain applicable documentation.
• Enters and reviews all pertinent information in EMR system, including authorizations and expiration dates.
• Meets 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.
• Analyzes data and reports to identify execution errors in workflow, 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 any noticed 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 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 to understand data flow through systems and system interaction.
• Preferred general knowledge of Medicare, Medicaid, and commercial health plan methodologies and documentation requirements.
• 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 related to health‑care administrative, financial, or insurance customer services, claims, billing, call center or management, regardless of industry.

• Work environment may be stressful at times, as 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 screens.
• 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 in writing with internal and external customers, demonstrating empathy, compassion, courtesy, and respect for privacy.
• Mental alertness to perform the essential functions of the position.

Mid‑Senior level

Full‑time

Management and Manufacturing

Hospitals and Health Care