Lead, PAP Specialist

AdaptHealth, LLC•Los Angeles, CA

About The Position

AdaptHealth Opportunity – Apply Today! At AdaptHealth we offer full-service home medical equipment products and services to empower patients to live their best lives – out of the hospital and in their homes. We are actively recruiting in your area. If you are passionate about making a profound impact on the quality of patients’ lives, please click to apply, we would love to hear from you. Lead PAP Specialist The Lead PAP Specialist is the subject matter expert and will be responsible for assisting leadership with oversight of the retail team. This individual will provide feedback, training, and guidance to ensure staff is following department protocol with processes. The Lead will handle escalated phone calls from patients or insurance companies that cannot be effectively resolved by staff. This individual will work closely with supervisor and Leadership to develop process improvements. Responsible for ensuring customers receive PAP equipment timely. Also responsible for ensuring audits are accurately completed and submitted on time. Responsible for monitoring, communicating, and managing all clients on Positive Airway Pressure devices and responds to patients needs in a way that are helpful and beyond expectation.

Requirements

High School Diploma required; Associated degree preferred.
Three (3) years’ work related in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry required.
Two (2) HME claims experience is preferred.
Exact job experience is considered any of the above tasks in a Medicare certified HME, IV or HH environment that routinely bills insurance.

Responsibilities

Review and analyze claim audits to ensure all responses are submitted and timely per Medicare and AdaptHealth guidelines.
Contact Medicare and other insurance carriers as needed for additional information regarding claim audits.
Ensure all AdaptHealth documents for patients are updated and formatted per Medicare and other healthcare criteria.
Review prescriptions and other paperwork as needed from other HME Partners to ensure Medicare compliance.
Explain compliance requirements to the customer to ensure they utilize the machine to their Insurance companies’ standards
Consistently answers emails concerning patients’ needs in a timely manner
Follows through on emails/phone calls until patient is taken care of
Makes recommendations for company equipment that will improve quality of care as appropriate
Successfully troubleshoots equipment problems over the phone
Understands and utilizes the most cost-effective delivery method for items ordered
Complete all orders received via CMB, email, fax, or phone in a timely manner
Through daily work activities identifies trends, either system or process driven, that can be changed or modified to improve efficiency and create cost savings
Other duties as assigned.