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Healthcare Quality Assurance Lead
2 months ago
AdaptHealth LLC is seeking a highly skilled Lead Quality Assurance Specialist to join our team. As a subject matter expert, you will be responsible for assisting leadership with oversight of the team, providing feedback, training, and guidance to ensure staff is following department protocol with processes.
The ideal candidate will have a strong understanding of quality assurance principles and be able to identify areas where technical solutions would improve business performance. You will work closely with supervisor and Leadership to develop process improvements and ensure successful service for our patients.
Key Responsibilities- Mentor and guide team members to ensure they are following department protocol and processes.
- Identify areas for improvement and develop solutions to enhance business performance.
- Provide training and guidance to staff to ensure they have the necessary skills and knowledge to perform their duties effectively.
- Assume responsibility for resolving team member escalations and work with multiple business partners to ensure consistent communication.
- 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.
- Accurately process, verify, and/or submit documentation and orders.
- Complete insurance verification to determine patient's eligibility, coverage, co-insurances, and deductibles.
- 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.
AdaptHealth LLC 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.
