Lead, Operations Specialist

AdaptHealth•Montgomery, AL

About The Position

The Lead Operations Specialist supports the Operations Team in meeting the individual needs of each region. This role serves as a subject matter expert, trains and mentors new and existing team members, and may deliver and set up medical equipment as needed. The position guides daily operations and complex case resolution, supports compliance with payer and regulatory requirements, and helps improve workflows and team performance. The role works with operational teams, leadership, and management on staffing, training, documentation, insurance matters, performance trends, and process improvements. It requires maintaining knowledge of AdaptHealth’s products and end-to-end customer service, intake, operations, and revenue cycle workflows. As needed, the specialist may perform patient assessments, deliver equipment, and drive a company vehicle. The role also includes on-call responsibilities outside business hours per company policy and adherence to patient confidentiality, HIPAA, infection-control, PPE, and hazardous-material procedures. This position involves physical work and travel, including moving equipment and supplies, driving, and accessing patients’ residences. The work environment may include stressful situations, unsanitary home settings, hazardous materials, infectious pathogens, loud noise, extreme temperatures, high-crime areas, and difficult customer interactions.

Requirements

High school diploma or equivalent.
Valid and unrestricted driver’s license in the state of residence.
Related experience in healthcare administrative, financial, or insurance customer service, claims, billing, call center, or management, regardless of industry.
Ability to communicate effectively verbally and in writing.
Ability to prioritize and manage multiple tasks.
Proficient computer skills and knowledge of Microsoft Office.
Ability to learn new technologies and technical aptitude to understand data flow through systems and system interactions.
Ability to work independently and as part of a group.
Ability to adapt and remain flexible in a rapidly changing environment; demonstrate patience, accountability, initiative, proactivity, and effective teamwork.
Ability to regularly lift or move up to 50 pounds, frequently lift or move up to 100 pounds, and occasionally lift or move up to 160 pounds.
Ability to stretch, bend, stoop, crouch, and perform moderate to heavy physical labor while moving equipment and supplies.
Ability to drive independently and travel as needed.
Ability to access patients’ residences without assistance.
Ability to communicate with customers while demonstrating empathy, compassion, courtesy, and respect for privacy.

Nice To Haves

Associate’s degree in healthcare administration, business administration, or a related field.
General knowledge of Medicare, Medicaid, and commercial health plan methodologies and documentation requirements.
Experience in a healthcare organization, a pharmacy that routinely bills insurance, or an organization providing diabetes supplies, medical supplies, HME, pharmacy, or Medicare-certified healthcare services.

Responsibilities

Supervise and guide team members in daily operations and complex case resolution, serving as the primary escalation point for difficult issues and regulatory compliance questions.
Lead team meetings, conduct onboarding, and facilitate ongoing training and staff development for operations and client engagement teams.
Monitor team performance metrics and productivity standards, and provide feedback and coaching.
Develop and implement process improvements and workflow optimization strategies; participate in defining, documenting, and refining procedures.
Coordinate with management on staffing needs, scheduling, and resource allocation.
Maintain expertise in Medicare guidelines, payer policies, clinical documentation, and regulatory changes to guide decisions and determine equipment and service qualification and compliance status.
Analyze data and reports to identify workflow errors, troubleshoot exceptions, advise staff on corrections, and collaborate on solutions.
Communicate process trends, insurance issues, and improvement opportunities to operations teams and leadership; prepare operational and performance trend reports for management.
Maintain working knowledge of AdaptHealth products, services, and customer service, intake, operations, and revenue cycle workflows.
Review, process, and verify documentation, including insurance eligibility, coverage, co-insurance, deductibles, and pre-authorization submissions.
Navigate multiple online EMR systems to obtain, enter, and review documentation, authorizations, and expiration dates.
Meet quality assurance requirements and key performance metrics with attention to detail and organization.
Listen to teams and leadership and handle stressful situations with compassion and empathy.
As needed, perform patient assessments and reassessments, deliver medical equipment, and safely drive and maintain a company vehicle.
Follow PPE, infection-control, and hazardous-material handling procedures.
Assume on-call responsibilities during non-business hours according to company policy.
Maintain patient confidentiality and comply with HIPAA and AdaptHealth’s Compliance Program.
Complete assigned compliance training and other required education.
Assist with projects and tasks and perform other related duties as assigned.

Benefits

Comprehensive medical, dental, and vision coverage, eligible the first of the month following hire.
401(k) with company match.
Paid time off plans, including six paid holidays.
Employee Stock Purchase Plan.
Paid parental bonding leave.
Short- and long-term disability insurance.
Life and AD&D insurance.
Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA).
CVS Minute Clinic and Teladoc access.
Spousal Advantage Reimbursement Plan.
Identity Theft Protection and Legal Plan.