Lead, Operations

About the Role

The Lead Operations Specialist is responsible for supporting the Operations Team through multiple tasks required for the successful support of each region’s individual needs. They serve as a subject matter expert, conduct new hire training, and mentor the team. As needed, they may deliver and set up medical equipment.

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/compliance status for equipment and services.
• Analyze data and reports to identify workflow errors, troubleshoot exceptions, and advise staff on corrections; 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 AdaptHealth's products, services, and end-to-end customer service, intake, operations, and revenue cycle workflows.
• Review, process, and verify documentation for accuracy, including insurance verification (eligibility, coverage, co-insurance, deductibles) and pre-authorization submissions to insurance carriers.
• Navigate multiple online EMR systems to obtain, enter, and review documentation, authorizations, and expiration dates.
• Meet quality assurance requirements and key performance metrics with strong attention to detail and organization.
• Actively listen to teams and leadership, handling stressful situations with compassion and empathy.
• As needed: perform patient assessments/re-assessments, deliver medical equipment, and safely drive/maintain a company vehicle.
• Retain knowledge of and adhere to PPE, infection control, and hazardous materials handling procedures.
• Assume on-call responsibilities during non-business hours per company policy.
• Maintain patient confidentiality and compliance with HIPAA and AdaptHealth's Compliance Program.
• Complete assigned compliance training and other required education.
• Assist with various projects and tasks as needed.
• Perform other related duties as assigned.

Qualifications

• High school diploma or equivalent required; Associate’s degree in healthcare administration, Business Administration, or related field preferred.
• Valid and unrestricted driver's license in the state of residence.
• Related experience in health care administrative, financial, or insurance customer services, claims, billing, call center, or management regardless of industry.

Skills

• 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 required to understand the flow of data through systems as well as system interaction.
• General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred.
• Work well independently and as part of a group.
• Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative, and work effectively on a team.

Physical Demands

• Must be able 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.
• Must be able to stretch, bend, stoop, and crouch and perform moderate to heavy physical labor while moving equipment and supplies.
• Subject to long periods of sitting and/or driving.
• Work environment may be stressful at times, as overall work activities and work levels fluctuate.
• May be exposed to unsanitary conditions in some home settings.
• May be exposed to hazardous materials, loud noise, extreme heat/cold, direct or indirect contact with airborne, bloodborne, and/or other potentially infectious pathogens.
• May be exposed to high-crime areas within the service community.
• Must be able to drive independently and travel as needed.
• May be exposed to angry or irate customers.
• Must be able to access the patient’s residence without assistance.

Benefits

• Comprehensive medical, dental, and vision coverage (eligible 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

Pay: $20 - $25/hour

AdaptHealth is an equal opportunity employer and does not unlawfully discriminate against employees or applicants for employment on the basis of an individual’s race, color, religion, creed, sex, national origin, age, disability, marital status, veteran status, sexual orientation, gender identity, genetic information, or any other status protected by applicable law.