Lead, Operations

AdaptHealth•Bremerton, WA

About The Position

The Lead Operations Specialist supports the Operations Team by completing tasks that address the needs of each region. The role serves as a subject matter expert, conducts new-hire training, and mentors team members. As needed, the Lead Operations Specialist may assess patients and deliver and set up medical equipment. The position guides team members in daily operations and complex case resolution, monitors performance, supports process improvements, and coordinates staffing and resources with management. It also requires advanced knowledge of Medicare guidelines, payer policies, clinical documentation, and regulatory changes, along with reviewing insurance and authorization documentation in multiple online EMR systems. The role may involve patient assessments, equipment delivery, driving and maintaining a company vehicle, and on-call responsibilities outside business hours. The Lead Operations Specialist must follow patient confidentiality, HIPAA, compliance, PPE, infection-control, and hazardous-materials procedures. The work includes substantial physical activity and may involve travel, driving, patient homes, and challenging or potentially hazardous conditions.

Requirements

High school diploma or equivalent required.
Valid and unrestricted driver's license in the state of residence.
Related experience in healthcare administrative, financial, or insurance customer services, 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 flows 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, accountability, proactivity, initiative, and effective teamwork.
Ability to regularly lift and/or move up to 50 pounds, frequently lift and/or move up to 100 pounds, and occasionally lift and/or move up to 160 pounds.
Ability to stretch, bend, stoop, and crouch and perform moderate to heavy physical labor while moving equipment and supplies.
Ability to sit and/or drive for long periods, drive independently, travel as needed, and access patient residences without assistance.
Ability to communicate effectively with customers and demonstrate 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 diabetic or medical supplies, HME, pharmacy, or Medicare-certified healthcare services.

Responsibilities

Supervise and guide team members in daily operations and complex case resolution; serve 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, providing feedback and coaching as needed.
Develop and implement process improvements and workflow optimization strategies; participate in defining, documenting, and refining procedures based on industry and company best practices.
Coordinate with management on staffing needs, scheduling, and resource allocation.
Maintain advanced expertise in Medicare guidelines, payer policies, clinical documentation, and regulatory changes to guide team decisions and determine qualification and compliance status for equipment and services.
Analyze data and reports to identify workflow errors, troubleshoot exceptions, advise staff on corrections, and collaborate with the Operations Team on solutions.
Communicate with operations teams and leadership on process trends, insurance issues, and improvement opportunities; prepare performance and operational trend reports for management review.
Maintain working knowledge of the company’s 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 while maintaining 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 per company policy.
Maintain patient confidentiality and comply with HIPAA and the company Compliance Program; complete assigned compliance training and other required education.
Assist with projects and 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 6 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 Teledoc access.
Spousal Advantage Reimbursement Plan.
Identity Theft Protection and Legal Plan.