Lead, Operations

AdaptHealth, LLC•Erie, PA

About The Position

The Lead Operations Specialist supports the Operations Team with tasks that address the needs of each region. This subject matter expert guides and mentors team members, conducts new-hire training, and may deliver and set up medical equipment as needed. The role supports operational performance, process improvement, documentation and insurance workflows, regulatory compliance, and customer service. It may also involve patient assessments, equipment delivery, driving a company vehicle, and on-call responsibilities outside business hours.

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.
Excellent verbal and written communication skills.
Ability to prioritize and manage multiple tasks.
Proficient computer skills and knowledge of Microsoft Office.
Ability to learn new technologies and understand data flow and system interactions.
Ability to work independently and as part of a group.
Ability to adapt and be flexible in a rapidly changing environment, demonstrate patience and accountability, take initiative, and work effectively on a team.

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, pharmacy that routinely bills insurance, or a business 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 performance metrics and productivity standards, providing feedback and coaching.
Develop and implement process improvements and workflow optimization strategies, and help define, document, and refine 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.
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.
Maintain knowledge of company products, services, and customer service, intake, operations, and revenue cycle workflows.
Review, process, and verify documentation, including insurance eligibility, coverage, co-insurance, deductibles, and prior authorization submissions.
Use 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 materials handling procedures.
Assume on-call responsibilities during non-business hours according to company policy.
Protect patient confidentiality and comply with HIPAA and the company's Compliance Program.
Complete assigned compliance training and other required education.
Assist with projects and other tasks as needed, 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.