[Remote] Intake Specialist-Quality Assurance-Remote Position-PST Time Zone

Note: The job is a remote job and is open to candidates in USA. AdaptHealth is a company that provides home medical equipment products and services to empower patients. The Intake Specialist role involves accurate data entry, communication with referral sources, and ensuring compliance in patient orders to enhance service delivery.

Responsibilities

• Accurately enters referrals within allotted timeframe as established; meeting productivity and quality standards as established
• Communicates with referral sources, physician, or associated staff to ensure documentation is routed to appropriate physician for signature/completion
• Works with leadership to ensure appropriate inventory/services are provided
• Communicates with patients regarding their financial responsibility, collects payment and documents in patient record accordingly
• For non-Medicaid patients communicate with patients
• Responsible for reviewing medical records for non-sales assisted referrals to ensure compliance standards are met prior to a service being rendered
• Follows company philosophies and procedures to ensure appropriate shipping method utilized for delivery of service
• Answers phone calls in a timely manner and assists caller
• Reviews medical records for non-sales assisted referrals to ensure compliance standards are met prior to a service being rendered
• Demonstrates expert knowledge of payer guidelines and reads clinical documentation to determine qualification status and compliance for all equipment and services
• Works with community referral sources to obtain compliant documentation in a timely manner to facilitate the referral process
• Contacts patients when documentation received does not meet payer guidelines, provide updates, and offer additional options to facilitate the referral process
• Works with sales team to obtain necessary documentation to facilitate referral process, as well as support referral source relationships
• Must be able to navigate through multiple online EMR systems to obtain applicable documentation
• Works with insurance verification team to ensure all needs are met for both teams to provide accurate information to the patient and ensure payments
• Assume on-call responsibilities during non-business hours in accordance with company policy
• Supervise and provide guidance to team members in daily operations and complex case resolution
• Lead team meetings and facilitate training sessions for staff development
• Monitor team performance metrics and productivity standards, providing feedback and coaching as needed
• Serve as primary escalation point for difficult customer issues and complex regulatory compliance questions
• Develop and implement process improvements and workflow optimization strategies
• Coordinate with management on staffing needs, scheduling, and resource allocation
• Conduct new employee onboarding and ongoing training programs
• Maintain advanced expertise in Medicare guidelines, payer policies, and regulatory changes to guide team decisions
• Prepare reports and analysis on team performance, trends, and operational metrics for management review
• Maintains patient confidentiality and functions within the guidelines of HIPAA
• Completes assigned compliance training and other education programs as required
• Maintains compliance with AdaptHealth's Compliance Program
• Performs other related duties as assigned

Skills

• High school diploma or equivalent required
• Related experience in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry
• Exact job experience is health care organization, pharmacy that routinely bills insurance or provides Diabetics, Medical Supplies, HME, Pharmacy or healthcare (Medicare certified) services
• One (1) year of work-related experience for Specialist Level (Entry Level)
• One (1) year of work-related experience plus Two (2) years exact job experience for Senior Level
• One (1) year of work-related experience plus Four (4) years exact job experience for Lead Level
• Ability to appropriately interact with patients, referral sources and staff
• Decision Making
• Analytical and problem-solving skills with attention to detail
• Strong verbal and written communication
• Excellent customer service and telephone service skills
• Proficient computer skills and knowledge of Microsoft Office
• Ability to prioritize and manage multiple tasks
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form
• Ability to work independently as well as follow detailed directives
• Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction
• Maintains patient confidentiality and functions within the guidelines of HIPAA
• Completes assigned compliance training and other education programs as required
• Maintains compliance with AdaptHealth's Compliance Program
• Associate's degree in healthcare administration, Business Administration, or related field

Company Overview

• AdaptHealth is a provider of home healthcare equipment, medical supplies to the home and related services in the United States. It was founded in 2012, and is headquartered in Phoenixville, Pennsylvania, USA, with a workforce of 10001+ employees. Its website is https://www.adapthealth.com/.

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