The Lead, Intake Specialist is the subject matter expert and will be responsible for assisting Intake leadership with oversight of the Intake team. This individual will provide feedback, training, and guidance to ensure Intake staff is following department protocol and processes. The Lead for Intake will handle escalated phone calls from patients or insurance companies that cannot be effectively resolved by staff. This individual will work closely with supervisor and Leadership to develop Intake process improvements. A Lead, Intake Specialist demonstrates advanced or expert knowledge, skills, and abilities as an Intake Specialist.Essential Functions and Job Responsibilities:
- Mentors, guides and provide oversight assistance of the team.
- Applying subject expertise in evaluating business operations and processes.
- Identifying areas where technical solutions would improve business performance.
- Consulting across teams, providing mentorship, and contributing specialized knowledge.
- Demonstrated various techniques and documentation to streamline production process.
- Identify team member strengths and opportunities and report findings up to supervisors.
- Respond to internal inquiries for coaching assistance via the subject matter expert queue, office communicator, and email.
- 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 calls.
- As a Subject Matter Expert, assist with training new employees and assist other staff with problems they encountered while interacting with members over the phone; addressed escalated customer questions and concerns.
- Performed ad hoc deep dive analyses for specific business problems.
- Training and development of team members to ensure AdaptHealth policy and protocol is being followed.
- Take escalated phone calls that cannot be effectively resolved by team members.
- Enters referrals within allotted timeframe as established; meets 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.
- Accurately enters referrals into appropriate system based on the type of referral obtained.
- Communicates with patients regarding their financial responsibility, collects payment and documents in patient record accordingly.
- Follows company philosophies and procedures to ensure appropriate shipping method utilized for delivery of service.
- 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.
- Navigates through multiple online EMR systems to obtain applicable documentation
- Works with verification team to ensure all needs are met for both teams to provide accurate information to the patient and ensure payments.
- Leads special projects or assignments and delegates responsibilities to others.
- Assume on-call responsibilities during non-business hours in accordance with company policy.
- Maintain patient confidentiality and function within the guidelines of HIPAA.
- Completes assigned compliance training and other educational programs as required.
- Maintains compliant with AdaptHealth's Compliance Program.
- Perform other related duties as assigned
RequirementsCompetency, Skills and Abilities:
- 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.
- Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction.
- Effective at developing relationships
- Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
Education and Experience Requirements:
- High School Diploma or equivalent required; Associated degree preferred
- Three (3) years' related experience in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry required
- Two (2) HME claims experience is preferred
- Exact job experience is considered any of the above tasks in a Medicare certified HME, Diabetic, home medical supplies, Pharmacy, HH environment that routinely bills insurance