[Hiring] Senior Quality Assurance Specialist @Adapthealth Llc
Mar 21, 2025 - Adapthealth Llc is hiring a remote Senior Quality Assurance Specialist. 💸 Salary: unspecified. 📍Location: USA.
Role Description
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.
- Develop and maintain working knowledge of current HME products and services offered by the company.
- Accurately enters patient notes and updates into patient records.
- Reviews documentation to make sure it is valid prior to processing an order to ensure completeness and accuracy.
- Verifies or obtains alternate contact information.
- Verifies delivery address, delivery instructions and telephone number for all orders.
- Understands and utilizes the most cost-effective delivery method for items ordered.
- Documents accounts with any delivery expectations and requests.
- Identifies trends, either system or process driven, that can be changed or modified to improve efficiency and create cost savings.
- Accurately process, verify, and/or submit documentation and orders.
- Complete insurance verification to determine patient’s eligibility, coverage, co-insurances, and deductibles.
- Navigates through multiple online EMR systems to obtain applicable documentation.
- Enters and reviews all pertinent information in EMR system including authorizations and expiration dates.
- Communicates with leadership on an ongoing basis regarding any noticed trends with insurance companies.
- Verifies insurance carriers are listed in the company’s database system, if not requests the new carrier is entered.
- Meets quality assurance requirements and other key performance metrics.
- Maintains and reviews all required documentation for insurance coverage and reimbursement per insurance guidelines and company policy.
- Contacts AdaptHealth sales and/or operations teams, and physicians, to obtain additional supporting medical necessity documents.
- Reports to supervisor any apparent issues and coordinates submission of all required documentation.
- Assists with implementation of performance improvement program as it relates to billing and coding performance.
- Other duties as assigned.
Qualifications
- High School Diploma or equivalent.
- One (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.
Company Description
At 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 click to apply, we would love to hear from you.
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| 📍 | Be aware of the location restriction for this remote position: USA |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
|
Salary
💸
unspecified
|
Remote
Location
USA
|
|
Job Type
full-time
|
Posted
Mar 21, 2025
|
| 📍 | Be aware of the location restriction for this remote position: USA |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
