AdaptHealth · 5 hours ago
Lead, Quality Assurance Specialist
United States
Full-time
Remote
Senior LevelAdaptHealth is a company that offers full-service home medical equipment products and services to empower patients. They are seeking a Lead Quality Assurance Specialist who will mentor the team, ensure compliance with standards, and handle escalated issues from patients or insurance companies.
Health CareHospitalMedical Device
Responsibilities
Mentors, guides and provide oversight assistance of the team
Identifying areas where technical solutions would improve business performance
Demonstrated various techniques and documentation to streamline production process
Identify team member strengths and opportunities and report findings up to supervisors
Assume responsibility for resolving team member escalations by working with multiple business partners while consistent communication is present with the member
Coach others on how to navigate through systems to find information needed for patients and calls
As a Subject Matter Expert, assist with training new employees and assist others with problems they encountered while interacting with members over the phone; addressed escalated customer questions and concerns
Accurately process, verify, and/or submit documentation and orders
Complete insurance verification to determine patient’s eligibility, coverage, co-insurances, and deductibles
Must be able to navigate through multiple online EMR systems to obtain applicable documentation
Enter and review all pertinent information in EMR system including authorizations and expiration dates
Meet quality assurance requirements and other key performance metrics
Maintain and review all required documentation for insurance coverage and reimbursement per insurance guidelines and company policy
Assist with implementation of performance improvement program as it relates to billing and coding performance
Perform other related duties as assigned
Other duties as assigned
Qualification
Required
Subject matter expert in Quality Assurance
Experience in providing feedback, training, and guidance to staff
Ability to handle escalated phone calls from patients or insurance companies
Experience in developing process improvements
Understanding of front-end processes for successful patient service
Ability to review delivery/shipping tickets and on-site orders for compliance
Knowledge of accreditation and payer regulations/guidelines
Experience in confirming delivery tickets in billing systems
Mentoring and guiding team members
Identifying areas for technical solutions to improve business performance
Demonstrated techniques and documentation to streamline production processes
Identifying team member strengths and opportunities
Resolving team member escalations with business partners
Coaching on navigation through systems for patient information
Training new employees and assisting with escalated customer questions
Accurate processing, verification, and submission of documentation and orders
Completing insurance verification for patient eligibility and coverage
Navigating multiple online EMR systems
Entering and reviewing information in EMR systems
Meeting quality assurance requirements and key performance metrics
Maintaining documentation for insurance coverage and reimbursement
Assisting with performance improvement programs related to billing and coding
Company
AdaptHealth
AdaptHealth is a provider of home healthcare equipment, medical supplies to the home and related services in the United States.
Founded in 2012
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$1.95BKey Investors
One Equity PartnersThe Firmament GroupDeerfield
2024-09-16Post Ipo Debt· $950M
2021-04-26Post Ipo Debt· $300M
2020-07-02Post Ipo Equity· $2.25M
Leadership Team
Suzanne Foster
Chief Executive Officer
Albert Prast
Chief Technology Officer
Recent News
Company data provided by crunchbase