Quality Assurance Specialist

Quality Assurance SpecialistAt 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 apply.The Quality Assurance Specialist is responsible for reviewing delivery/shipping tickets and on-site orders to ensure AdaptHealth is meeting compliance standards according to accreditation and payer regulations/guidelines prior to confirming the delivery ticket in our billing system. Their review will include, but not limited to, things such as proof of delivery standards and accuracy of CMS or managed care payer billing guidelines. The Quality Assurance Specialist will be responsible for confirming all delivery/shipping tickets and on-site orders daily as received from the regions and indexing each ticket onto the appropriate EMR after confirmation.Job Duties:Develop and maintain working knowledge of current HME products and services offered by the company.Accurately enter patient notes and updates into patient recordsReviews documentation to make sure it is valid prior to processing an order to ensure completeness and accuracy.Verifies or obtains alternate contact informationVerifies delivery address, delivery instructions and telephone number for all ordersUnderstands and utilizes the most cost-effective delivery method for items orderedDocuments accounts with any delivery expectations and requestsThrough daily work activities identifies trends, either system or process driven, that can be changed or modified to improve efficiency and create cost savingsAccurately process, verify, and/or submit documentation and ordersComplete insurance verification to determine patient's eligibility, coverage, co-insurances, and deductiblesMust be able to navigate through multiple online EMR systems to obtain applicable documentationEnter and review all pertinent information in EMR system including authorizations and expiration datesCommunicate with leadership on an on-going basis regarding any noticed trends with insurance companiesVerify insurance carriers are listed in the company's database system, if not request the new carrier is enteredMeet quality assurance requirements and other key performance metricsMaintain and review all required documentation for insurance coverage and reimbursement per insurance guidelines and company policyContact AdaptHealth sales and/or operations teams, and physicians, to obtain additional supporting medical necessity documentsReport to supervisor any apparent issues and coordinate submission of all required documentation.Assist with implementation of performance improvement program as it relates to billing and coding performance.Other duties as assigned.RequirementsMinimum Job Qualifications:High School Diploma or equivalentOne (1) year work related experience in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry.Senior level requires two (2) years of work-related experience and one (1) year of exact job experience.Exact job experience is considered any of the above tasks in a Medicare certified HME, Diabetic, Pharmacy, or home medical supplies environment that routinely bills insurance.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. This policy applies to all terms, conditions, and privileges of employment, including recruitment, hiring, placement, compensation, promotion, discipline, and termination.