AdaptHealth

Provide leadership and mentorship to RCM teams, handle escalated inquiries, identify process improvements, and ensure compliance with billing and insurance guidelines. | Requires 3+ years healthcare administrative or billing experience, preferably 2 years in HME or home medical supplies environment, strong communication and problem-solving skills, and a high school diploma with an associate degree preferred. | Note: The job is a remote job and is open to candidates in USA. AdaptHealth is a company focused on revenue cycle management, and they are seeking a Lead, Revenue Cycle Management Specialist. This role involves providing leadership oversight to RCM teams, mentoring staff, handling escalated inquiries, and identifying trends to improve processes within the department. Responsibilities • Mentors guide and provide oversight assistance to the team. The majority of AdaptHealth RCM team members are located offshore. • 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 the production process. • Identify team members' strengths and opportunities and report findings 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 CSRs 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 are being followed. • Take escalated phone calls that cannot be effectively resolved by team members. • Communicate with other departments, front end staff regarding billing issues and trends to work toward an account resolution and decrease insurance denial percentages within AdaptHealth. • Handle all insurance payer disputes that are filtered into the department. • Identify trends and root causes related to inaccurate insurance billing, and report to the manager while resolving account errors. • Assists in conducting team meetings to educate on insurance guidelines, claim denials, and re-training efforts on accounts incorrectly worked. • Develops and enhances the process and payer-specific work job aids and standard operating procedures. • Investigate escalated insurance billing inquiries and inaccuracies and take appropriate action to resolve the account. • Provides quality payer feedback to other AdaptHealth leadership. • Develop and maintain a working knowledge of current AdaptHealth products and services offered by the company. • Maintain patient confidentiality and function within the guidelines of HIPAA. • Completes assigned compliance training and other educational programs as required. • Maintains compliance with AdaptHealth’s Compliance Program. • Perform other related duties as assigned. Skills • Three (3) years related work experience in health care administrative, financial, insurance, customer services, claims, billing, call center, or management regardless of industry required • Two (2) exact job experience in HME, Diabetic, home medical supplies, Pharmacy, HH environment is preferred • Exact job experience is considered any of the above tasks in a Medicare-certified HME, IV, or HH environment that routinely bills insurance • Decision Making • Strong analytical and problem-solving skills with attention to detail • Excellent verbal and written communication • Excellent customer service skills • Proficient computer skills and knowledge of Microsoft Office • Ability to prioritize and manage multiple projects • Solid ability to learn new technologies and possess the technical aptitude required to understand the flow of data through systems as well as system interaction • Understanding and identifying priority orders • Extensive knowledge of products offered and the required paperwork to ensure we can bill for those products • Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form • Associated degree preferred • Two (2) exact job experience in HME, Diabetic, home medical supplies, Pharmacy, HH environment is preferred Education Requirements • High School Diploma required; Associated degree preferred 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/.

Oversee regional client relationships, monitor service performance, drive operational improvements, coordinate communication, and manage issue resolution to ensure contractual commitments are met. | Bachelor's degree, 5+ years in client relationship or healthcare operations, contract management experience, healthcare payer/referral knowledge preferred, and valid driver's license. | Apply Description Position Summary The Regional Program Manager serves as a regional manager responsible for overseeing regional client relationships with payers and referral sources, monitoring service performance, and driving operational improvements. This role coordinates communications, manages expectations, and facilitates resolution management with AdaptHealth teams for specific client agreements. The primary objective is to ensure contractual commitments are met or exceeded while supporting business needs through effective communication, reporting, and continuous improvement initiatives. Essential Functions & Responsibilities Regional Client Management • Oversee payer and referral source relationships within assigned region. • Manage client expectations and maintain ongoing communication. • Coordinate with AdaptHealth teams to support specific client agreements. • Monitor compliance with contractual obligations and service level agreements. • Provide specialized support for large, capitated contracts and strategic accounts. • Ensure high-touch service delivery for enterprise-level client relationships. Performance Monitoring and Improvement • Track service performance metrics against established benchmarks. • Identify areas for operational improvements and efficiency gains. • Collaborate with internal teams to implement process enhancements. • Ensure contractual commitments are consistently met or exceeded. Communication and Coordination • Facilitate communication between clients, internal teams, and stakeholders. • Prepare and distribute performance reports and status updates. • Coordinate cross-functional meetings and project activities. • Maintain documentation of client interactions and service delivery. Issue Resolution Management • Lead resolution efforts for escalated customer and client issues. • Work with AdaptHealth teams to address service-related concerns. • Document resolution processes and outcomes. • Implement preventive measures to reduce future escalations. • Promote the mission, vision, and values of the organization. Executive and Strategic Coordination • Collaborate closely with Regional Vice President, Operations on strategic initiatives and regional performance. • Work with Contract Management team to ensure contract compliance and support renewal processes. • Provide regular updates and recommendations to senior leadership on regional client performance. • Support strategic planning and business development activities within the region. • Develop and maintain working knowledge of current products and services offered by the company. • Maintain patient confidentiality and function within the guidelines of HIPAA. • Complete assigned compliance training and other educational programs as required. • Maintain compliance with AdaptHealth’s Compliance Program • Perform other related duties as assigned. Competency, Skills And Abilities • Exceptional communication and interpersonal skills for managing client relationships and cross-functional collaboration. • Advanced problem-solving and analytical thinking abilities to resolve complex operational issues. • Strong project coordination and organizational skills to manage multiple client agreements simultaneously. • Demonstrated ability to prioritize competing demands and meet critical deadlines. • Strategic vision and forward-thinking approach to regional business development • Decisive decision-making capabilities for resolving business problems and identifying priorities. • Client-focused leadership approach with emphasis on service excellence • Adaptability and resilience in dynamic healthcare environment • High-level proficiency with Microsoft Office Suite (Excel, Outlook, PowerPoint) • Experience with reporting tools and data management systems • Ability to create and analyze performance metrics and dashboards. • Comprehensive understanding of healthcare payer systems and reimbursement processes • Working knowledge of service level agreements and contract terms • Familiarity with quality assurance and performance improvement methodologies • Understanding of healthcare referral networks and provider relationships • Knowledge of operational processes, contract law, and financial management principles • Team development and mentoring capabilities (though role has no direct reports) • Financial acumen for understanding contract performance and business impact. • Ability to influence and coordinate across departments without direct authority. Requirements Education and Experience Requirements: • Bachelor's degree in relevant field • Five (5) years’ experience in client relationship management or healthcare operations • Experience with contract management and performance monitoring • Background in healthcare payer or referral relationships preferred. • Valid and unrestricted driver’s license in the state of residence Physical Demands And Work Environment • Must be able to bend, stoop, stretch, stand, and sit for extended periods. • Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use. • Work environment may be stressful at times, as overall office activities and work levels fluctuate. • Subject to long periods of sitting and exposure to computer screen. • May be exposed to angry or irate customers, patients, or referral sources. • Ability to utilize a personal computer and other office equipment. • Must be able to lift 30 pounds as needed. • Requires regular travel throughout the region. • Excellent ability to communicate both verbally and in writing.