Description: Position Summary: The Operations Specialist is responsible for supporting the Operations Team through multiple tasks required for the successful support of each regions individual needs. Essential Functions and Job Responsibilities: Supports operations team with discovery and training as necessary with AdaptHealth processes. Responsible for providing support during process improvement initiatives to assist with driving all areas of workflow, including verification, and data analysis. Develop and maintain working knowledge of current products and services offered by the company Must be familiar with payer guidelines and reading clinical documentation to determine qualification status and compliance for all equipment and services. Working knowledge in all areas of AdaptHealth customer service, intake, daily operations and revenue cycle processes and workflows from beginning to end, which may include Review all required documentation to ensure accuracy Accurately process, verify, and/or submit documentation Complete insurance verification to determine patients eligibility, coverage, co-insurances, and deductibles Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required (if helping a region) Navigate through multiple online EMR systems to obtain applicable documentation Enter and review all pertinent information in EMR system including authorizations and expiration dates Meet quality assurance requirements and other key performance metrics Pays attention to detail and has great organizational skills Actively listens to teams, region leaders and handle stressful situations with compassion and empathy. Ability to analyze data and reports to identify execution errors in workflow, troubleshoot and fix the exceptions, advise staff on corrections. Collaborate with the Operations Team on exceptions and solutions within workflow processes Communicate with operations teams and leadership on an on-going basis regarding any noticed trends in process errors with insurance companies Assist with various projects and tasks as needed for various unique processes Participate in the effort to define, document, and refine processes, procedures and workflows for business operations based on industry and company best-practices. Participate in the effort to create training materials and train client engagement and service teams Maintain patient confidentiality and function within the guidelines of HIPAA. Completes assigned compliance training and other educational programs as required. Maintains compliant with AdaptHealths Compliance Program. Perform other related duties as assigned. Competency, Skills and Abilities: Excellent ability to communicate both verbally and in writing Ability to prioritize and manage multiple tasks Proficient computer skills and knowledge of Microsoft Office Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred. Work well independently and as part of a group Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative and work effectively on a team Requirements: Education and Experience Requirements: High School Diploma or equivalency Three (3) years work related in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry is required. Physical Demands and Work Environment: Work environment will be stressful at times, as overall office activities and work levels fluctuate Must be able to bend, stoop, stretch, stand, and sit for extended periods of time Subject to long periods of sitting and exposure to computer screen Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use Excellent ability to communicate both verbally and in writing Ability to effectively communicate both verbally and written with internal and external customers with the ability to demonstrate empathy, compassion, courtesy, and respect for privacy. Mental alertness to perform the essential functions of position. Compensation details: 19-23 Hourly Wage PIe111e8640e93-4204
12/04/2025
Full time
Description: Position Summary: The Operations Specialist is responsible for supporting the Operations Team through multiple tasks required for the successful support of each regions individual needs. Essential Functions and Job Responsibilities: Supports operations team with discovery and training as necessary with AdaptHealth processes. Responsible for providing support during process improvement initiatives to assist with driving all areas of workflow, including verification, and data analysis. Develop and maintain working knowledge of current products and services offered by the company Must be familiar with payer guidelines and reading clinical documentation to determine qualification status and compliance for all equipment and services. Working knowledge in all areas of AdaptHealth customer service, intake, daily operations and revenue cycle processes and workflows from beginning to end, which may include Review all required documentation to ensure accuracy Accurately process, verify, and/or submit documentation Complete insurance verification to determine patients eligibility, coverage, co-insurances, and deductibles Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required (if helping a region) Navigate through multiple online EMR systems to obtain applicable documentation Enter and review all pertinent information in EMR system including authorizations and expiration dates Meet quality assurance requirements and other key performance metrics Pays attention to detail and has great organizational skills Actively listens to teams, region leaders and handle stressful situations with compassion and empathy. Ability to analyze data and reports to identify execution errors in workflow, troubleshoot and fix the exceptions, advise staff on corrections. Collaborate with the Operations Team on exceptions and solutions within workflow processes Communicate with operations teams and leadership on an on-going basis regarding any noticed trends in process errors with insurance companies Assist with various projects and tasks as needed for various unique processes Participate in the effort to define, document, and refine processes, procedures and workflows for business operations based on industry and company best-practices. Participate in the effort to create training materials and train client engagement and service teams Maintain patient confidentiality and function within the guidelines of HIPAA. Completes assigned compliance training and other educational programs as required. Maintains compliant with AdaptHealths Compliance Program. Perform other related duties as assigned. Competency, Skills and Abilities: Excellent ability to communicate both verbally and in writing Ability to prioritize and manage multiple tasks Proficient computer skills and knowledge of Microsoft Office Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred. Work well independently and as part of a group Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative and work effectively on a team Requirements: Education and Experience Requirements: High School Diploma or equivalency Three (3) years work related in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry is required. Physical Demands and Work Environment: Work environment will be stressful at times, as overall office activities and work levels fluctuate Must be able to bend, stoop, stretch, stand, and sit for extended periods of time Subject to long periods of sitting and exposure to computer screen Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use Excellent ability to communicate both verbally and in writing Ability to effectively communicate both verbally and written with internal and external customers with the ability to demonstrate empathy, compassion, courtesy, and respect for privacy. Mental alertness to perform the essential functions of position. Compensation details: 19-23 Hourly Wage PIe111e8640e93-4204
Description: Position Summary: The Operations Specialist is responsible for supporting the Operations Team through multiple tasks required for the successful support of each region's individual needs. Essential Functions and Job Responsibilities: Supports operations team with discovery and training as necessary with AdaptHealth processes. Responsible for providing support during process improvement initiatives to assist with driving all areas of workflow, including verification, and data analysis. Develop and maintain working knowledge of current products and services offered by the company Must be familiar with payer guidelines and reading clinical documentation to determine qualification status and compliance for all equipment and services. Working knowledge in all areas of AdaptHealth customer service, intake, daily operations and revenue cycle processes and workflows from beginning to end, which may include Review all required documentation to ensure accuracy Accurately process, verify, and/or submit documentation Complete insurance verification to determine patient's eligibility, coverage, co-insurances, and deductibles Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required (if helping a region) Navigate through multiple online EMR systems to obtain applicable documentation Enter and review all pertinent information in EMR system including authorizations and expiration dates Meet quality assurance requirements and other key performance metrics Pays attention to detail and has great organizational skills Actively listens to teams, region leaders and handle stressful situations with compassion and empathy. Ability to analyze data and reports to identify execution errors in workflow, troubleshoot and fix the exceptions, advise staff on corrections. Collaborate with the Operations Team on exceptions and solutions within workflow processes Communicate with operations teams and leadership on an on-going basis regarding any noticed trends in process errors with insurance companies Assist with various projects and tasks as needed for various unique processes Participate in the effort to define, document, and refine processes, procedures and workflows for business operations based on industry and company best-practices. Participate in the effort to create training materials and train client engagement and service teams 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. Competency, Skills and Abilities: Excellent ability to communicate both verbally and in writing Ability to prioritize and manage multiple tasks Proficient computer skills and knowledge of Microsoft Office Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred. Work well independently and as part of a group Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative and work effectively on a team Requirements: Education and Experience Requirements: High School Diploma or equivalency Three (3) years' work related in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry is required. Physical Demands and Work Environment: Work environment will be stressful at times, as overall office activities and work levels fluctuate Must be able to bend, stoop, stretch, stand, and sit for extended periods of time Subject to long periods of sitting and exposure to computer screen Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use Excellent ability to communicate both verbally and in writing Ability to effectively communicate both verbally and written with internal and external customers with the ability to demonstrate empathy, compassion, courtesy, and respect for privacy. Mental alertness to perform the essential functions of position. Compensation details: 19-23 Hourly Wage PIbec74516e08a-4204
12/04/2025
Full time
Description: Position Summary: The Operations Specialist is responsible for supporting the Operations Team through multiple tasks required for the successful support of each region's individual needs. Essential Functions and Job Responsibilities: Supports operations team with discovery and training as necessary with AdaptHealth processes. Responsible for providing support during process improvement initiatives to assist with driving all areas of workflow, including verification, and data analysis. Develop and maintain working knowledge of current products and services offered by the company Must be familiar with payer guidelines and reading clinical documentation to determine qualification status and compliance for all equipment and services. Working knowledge in all areas of AdaptHealth customer service, intake, daily operations and revenue cycle processes and workflows from beginning to end, which may include Review all required documentation to ensure accuracy Accurately process, verify, and/or submit documentation Complete insurance verification to determine patient's eligibility, coverage, co-insurances, and deductibles Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required (if helping a region) Navigate through multiple online EMR systems to obtain applicable documentation Enter and review all pertinent information in EMR system including authorizations and expiration dates Meet quality assurance requirements and other key performance metrics Pays attention to detail and has great organizational skills Actively listens to teams, region leaders and handle stressful situations with compassion and empathy. Ability to analyze data and reports to identify execution errors in workflow, troubleshoot and fix the exceptions, advise staff on corrections. Collaborate with the Operations Team on exceptions and solutions within workflow processes Communicate with operations teams and leadership on an on-going basis regarding any noticed trends in process errors with insurance companies Assist with various projects and tasks as needed for various unique processes Participate in the effort to define, document, and refine processes, procedures and workflows for business operations based on industry and company best-practices. Participate in the effort to create training materials and train client engagement and service teams 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. Competency, Skills and Abilities: Excellent ability to communicate both verbally and in writing Ability to prioritize and manage multiple tasks Proficient computer skills and knowledge of Microsoft Office Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred. Work well independently and as part of a group Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative and work effectively on a team Requirements: Education and Experience Requirements: High School Diploma or equivalency Three (3) years' work related in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry is required. Physical Demands and Work Environment: Work environment will be stressful at times, as overall office activities and work levels fluctuate Must be able to bend, stoop, stretch, stand, and sit for extended periods of time Subject to long periods of sitting and exposure to computer screen Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use Excellent ability to communicate both verbally and in writing Ability to effectively communicate both verbally and written with internal and external customers with the ability to demonstrate empathy, compassion, courtesy, and respect for privacy. Mental alertness to perform the essential functions of position. Compensation details: 19-23 Hourly Wage PIbec74516e08a-4204
Description: Position Summary: The Operations Specialist is responsible for supporting the Operations Team through multiple tasks required for the successful support of each regions individual needs. Essential Functions and Job Responsibilities: Supports operations team with discovery and training as necessary with AdaptHealth processes. Responsible for providing support during process improvement initiatives to assist with driving all areas of workflow, including verification, and data analysis. Develop and maintain working knowledge of current products and services offered by the company Must be familiar with payer guidelines and reading clinical documentation to determine qualification status and compliance for all equipment and services. Working knowledge in all areas of AdaptHealth customer service, intake, daily operations and revenue cycle processes and workflows from beginning to end, which may include Review all required documentation to ensure accuracy Accurately process, verify, and/or submit documentation Complete insurance verification to determine patients eligibility, coverage, co-insurances, and deductibles Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required (if helping a region) Navigate through multiple online EMR systems to obtain applicable documentation Enter and review all pertinent information in EMR system including authorizations and expiration dates Meet quality assurance requirements and other key performance metrics Pays attention to detail and has great organizational skills Actively listens to teams, region leaders and handle stressful situations with compassion and empathy. Ability to analyze data and reports to identify execution errors in workflow, troubleshoot and fix the exceptions, advise staff on corrections. Collaborate with the Operations Team on exceptions and solutions within workflow processes Communicate with operations teams and leadership on an on-going basis regarding any noticed trends in process errors with insurance companies Assist with various projects and tasks as needed for various unique processes Participate in the effort to define, document, and refine processes, procedures and workflows for business operations based on industry and company best-practices. Participate in the effort to create training materials and train client engagement and service teams Maintain patient confidentiality and function within the guidelines of HIPAA. Completes assigned compliance training and other educational programs as required. Maintains compliant with AdaptHealths Compliance Program. Perform other related duties as assigned. Competency, Skills and Abilities: Excellent ability to communicate both verbally and in writing Ability to prioritize and manage multiple tasks Proficient computer skills and knowledge of Microsoft Office Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred. Work well independently and as part of a group Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative and work effectively on a team Requirements: Education and Experience Requirements: High School Diploma or equivalency Three (3) years work related in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry is required. Physical Demands and Work Environment: Work environment will be stressful at times, as overall office activities and work levels fluctuate Must be able to bend, stoop, stretch, stand, and sit for extended periods of time Subject to long periods of sitting and exposure to computer screen Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use Excellent ability to communicate both verbally and in writing Ability to effectively communicate both verbally and written with internal and external customers with the ability to demonstrate empathy, compassion, courtesy, and respect for privacy. Mental alertness to perform the essential functions of position. Compensation details: 19-23 Hourly Wage PIc1b3d491006c-4201
12/03/2025
Full time
Description: Position Summary: The Operations Specialist is responsible for supporting the Operations Team through multiple tasks required for the successful support of each regions individual needs. Essential Functions and Job Responsibilities: Supports operations team with discovery and training as necessary with AdaptHealth processes. Responsible for providing support during process improvement initiatives to assist with driving all areas of workflow, including verification, and data analysis. Develop and maintain working knowledge of current products and services offered by the company Must be familiar with payer guidelines and reading clinical documentation to determine qualification status and compliance for all equipment and services. Working knowledge in all areas of AdaptHealth customer service, intake, daily operations and revenue cycle processes and workflows from beginning to end, which may include Review all required documentation to ensure accuracy Accurately process, verify, and/or submit documentation Complete insurance verification to determine patients eligibility, coverage, co-insurances, and deductibles Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required (if helping a region) Navigate through multiple online EMR systems to obtain applicable documentation Enter and review all pertinent information in EMR system including authorizations and expiration dates Meet quality assurance requirements and other key performance metrics Pays attention to detail and has great organizational skills Actively listens to teams, region leaders and handle stressful situations with compassion and empathy. Ability to analyze data and reports to identify execution errors in workflow, troubleshoot and fix the exceptions, advise staff on corrections. Collaborate with the Operations Team on exceptions and solutions within workflow processes Communicate with operations teams and leadership on an on-going basis regarding any noticed trends in process errors with insurance companies Assist with various projects and tasks as needed for various unique processes Participate in the effort to define, document, and refine processes, procedures and workflows for business operations based on industry and company best-practices. Participate in the effort to create training materials and train client engagement and service teams Maintain patient confidentiality and function within the guidelines of HIPAA. Completes assigned compliance training and other educational programs as required. Maintains compliant with AdaptHealths Compliance Program. Perform other related duties as assigned. Competency, Skills and Abilities: Excellent ability to communicate both verbally and in writing Ability to prioritize and manage multiple tasks Proficient computer skills and knowledge of Microsoft Office Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred. Work well independently and as part of a group Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative and work effectively on a team Requirements: Education and Experience Requirements: High School Diploma or equivalency Three (3) years work related in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry is required. Physical Demands and Work Environment: Work environment will be stressful at times, as overall office activities and work levels fluctuate Must be able to bend, stoop, stretch, stand, and sit for extended periods of time Subject to long periods of sitting and exposure to computer screen Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use Excellent ability to communicate both verbally and in writing Ability to effectively communicate both verbally and written with internal and external customers with the ability to demonstrate empathy, compassion, courtesy, and respect for privacy. Mental alertness to perform the essential functions of position. Compensation details: 19-23 Hourly Wage PIc1b3d491006c-4201
BPO Hunting Sales - Service Line Specialist - IOA (Intelligent Operations and Automation) Location: West coast and Central Candidates Preferred Level: Director About the Role We are seeking a seasoned Service Line Specialist to join our Intelligent Operations and Automation (IOA) business within the Communications, Media, and Technology (CMT) team. This individual contributor role is pivotal in driving growth and innovation in our BPO/Digital Operations segment. The ideal candidate will possess 15-25 years of experience with a strong track record in consultative and empathetic selling, particularly within SaaS, online, and platform-based businesses. The role demands a dynamic professional who is well-networked within the technology and digital native industry and understands the culture and vibe of this fast-paced ecosystem. While the candidate will own and manage existing client relationships, 50-70% of the focus will be on acquiring new logos and expanding our footprint. The ability to navigate complex internal and external stakeholder environments to close large multi-million dollar deals is essential. Work model: We believe hybrid work is the way forward as we strive to provide flexibility wherever possible. Based on this role's business requirements, this position requires 3 days a week at the Client/Cognizant site mainly in the Bay Area / California / Washington area. Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs. The working arrangements for this role are accurate as of the date of posting. This may change based on the project you're engaged in, as well as business and client requirements. Rest assured; we will always be clear about role expectations. In this role, you will: Drive portfolio growth and strategy development across performance metrics for the assigned portfolio. Provide thought leadership, leading the mind-share conversation across client leadership levels and internal senior management. Partner with industry bodies, analysts, and advisors to align Cognizant's strategic priorities for the industry segment and service offerings. Develop positive relationships with senior client executives and partner for mutual success. Drive outstanding client propositions, partnering with Solutions, Delivery, Process Excellence, and Automation teams. Lead end-to-end management of the account operations including account forecasting, budgeting, and overall P&L. Manage accountability against Measurable Revenue/Profit Growth within set timelines. What you need to have to be considered: Solid knowledge of the technology industry, particularly with large tech platform companies. Experience leading an annual revenue scale of $20Mn+ and handling TCV of $10-30Mn. Extensive experience in the scale operations domain, advising clients on strategic priorities including but not limited to optimum location strategy, business value proposition, engagement model transformations, and demonstrating industry standard methodologies. Relationships at senior levels within the relevant industry segments, especially in the Alphabet group companies. Exposure across operations service domains including Enterprise services, Digital customer experience, ML operations, and Content services. Minimum of 15-25 years of industry experience preferred with a minimum of the last 10+ years in the Digital native technical landscape. Knowledge of how matrix structures work across global markets. Strong analytical and consultative selling approach. We're excited to meet go-getters who believe they can make an impact and share our mission. Don't hesitate to apply, even if you only meet the minimum requirements listed. Think about your transferable experiences and unique skills that make you stand out as someone who can bring new and exciting things to this role. The annual base salary for this position is between $198,000 - $218,000. The specific salary is dependent on experience and other qualifications. This position is also eligible for Cognizant's discretionary annual incentive program, based on performance and subject to the terms of Cognizant's applicable plans. Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements: Medical/Dental/Vision/Life Insurance Paid holidays plus Paid Time Off 401(k) plan and contributions Long-term/Short-term Disability Paid Parental Leave Employee Stock Purchase Plan
12/03/2025
Full time
BPO Hunting Sales - Service Line Specialist - IOA (Intelligent Operations and Automation) Location: West coast and Central Candidates Preferred Level: Director About the Role We are seeking a seasoned Service Line Specialist to join our Intelligent Operations and Automation (IOA) business within the Communications, Media, and Technology (CMT) team. This individual contributor role is pivotal in driving growth and innovation in our BPO/Digital Operations segment. The ideal candidate will possess 15-25 years of experience with a strong track record in consultative and empathetic selling, particularly within SaaS, online, and platform-based businesses. The role demands a dynamic professional who is well-networked within the technology and digital native industry and understands the culture and vibe of this fast-paced ecosystem. While the candidate will own and manage existing client relationships, 50-70% of the focus will be on acquiring new logos and expanding our footprint. The ability to navigate complex internal and external stakeholder environments to close large multi-million dollar deals is essential. Work model: We believe hybrid work is the way forward as we strive to provide flexibility wherever possible. Based on this role's business requirements, this position requires 3 days a week at the Client/Cognizant site mainly in the Bay Area / California / Washington area. Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs. The working arrangements for this role are accurate as of the date of posting. This may change based on the project you're engaged in, as well as business and client requirements. Rest assured; we will always be clear about role expectations. In this role, you will: Drive portfolio growth and strategy development across performance metrics for the assigned portfolio. Provide thought leadership, leading the mind-share conversation across client leadership levels and internal senior management. Partner with industry bodies, analysts, and advisors to align Cognizant's strategic priorities for the industry segment and service offerings. Develop positive relationships with senior client executives and partner for mutual success. Drive outstanding client propositions, partnering with Solutions, Delivery, Process Excellence, and Automation teams. Lead end-to-end management of the account operations including account forecasting, budgeting, and overall P&L. Manage accountability against Measurable Revenue/Profit Growth within set timelines. What you need to have to be considered: Solid knowledge of the technology industry, particularly with large tech platform companies. Experience leading an annual revenue scale of $20Mn+ and handling TCV of $10-30Mn. Extensive experience in the scale operations domain, advising clients on strategic priorities including but not limited to optimum location strategy, business value proposition, engagement model transformations, and demonstrating industry standard methodologies. Relationships at senior levels within the relevant industry segments, especially in the Alphabet group companies. Exposure across operations service domains including Enterprise services, Digital customer experience, ML operations, and Content services. Minimum of 15-25 years of industry experience preferred with a minimum of the last 10+ years in the Digital native technical landscape. Knowledge of how matrix structures work across global markets. Strong analytical and consultative selling approach. We're excited to meet go-getters who believe they can make an impact and share our mission. Don't hesitate to apply, even if you only meet the minimum requirements listed. Think about your transferable experiences and unique skills that make you stand out as someone who can bring new and exciting things to this role. The annual base salary for this position is between $198,000 - $218,000. The specific salary is dependent on experience and other qualifications. This position is also eligible for Cognizant's discretionary annual incentive program, based on performance and subject to the terms of Cognizant's applicable plans. Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements: Medical/Dental/Vision/Life Insurance Paid holidays plus Paid Time Off 401(k) plan and contributions Long-term/Short-term Disability Paid Parental Leave Employee Stock Purchase Plan
Description: Position Summary: The Operations Specialist is responsible for supporting the Operations Team through multiple tasks required for the successful support of each region's individual needs. Essential Functions and Job Responsibilities: Supports operations team with discovery and training as necessary with AdaptHealth processes. Responsible for providing support during process improvement initiatives to assist with driving all areas of workflow, including verification, and data analysis. Develop and maintain working knowledge of current products and services offered by the company Must be familiar with payer guidelines and reading clinical documentation to determine qualification status and compliance for all equipment and services. Working knowledge in all areas of AdaptHealth customer service, intake, daily operations and revenue cycle processes and workflows from beginning to end, which may include Review all required documentation to ensure accuracy Accurately process, verify, and/or submit documentation Complete insurance verification to determine patient's eligibility, coverage, co-insurances, and deductibles Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required (if helping a region) Navigate through multiple online EMR systems to obtain applicable documentation Enter and review all pertinent information in EMR system including authorizations and expiration dates Meet quality assurance requirements and other key performance metrics Pays attention to detail and has great organizational skills Actively listens to teams, region leaders and handle stressful situations with compassion and empathy. Ability to analyze data and reports to identify execution errors in workflow, troubleshoot and fix the exceptions, advise staff on corrections. Collaborate with the Operations Team on exceptions and solutions within workflow processes Communicate with operations teams and leadership on an on-going basis regarding any noticed trends in process errors with insurance companies Assist with various projects and tasks as needed for various unique processes Participate in the effort to define, document, and refine processes, procedures and workflows for business operations based on industry and company best-practices. Participate in the effort to create training materials and train client engagement and service teams 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. Competency, Skills and Abilities: Excellent ability to communicate both verbally and in writing Ability to prioritize and manage multiple tasks Proficient computer skills and knowledge of Microsoft Office Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred. Work well independently and as part of a group Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative and work effectively on a team Requirements: Education and Experience Requirements: High School Diploma or equivalency Three (3) years' work related in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry is required. Physical Demands and Work Environment: Work environment will be stressful at times, as overall office activities and work levels fluctuate Must be able to bend, stoop, stretch, stand, and sit for extended periods of time Subject to long periods of sitting and exposure to computer screen Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use Excellent ability to communicate both verbally and in writing Ability to effectively communicate both verbally and written with internal and external customers with the ability to demonstrate empathy, compassion, courtesy, and respect for privacy. Mental alertness to perform the essential functions of position. Compensation details: 19-23 Hourly Wage PI60c7f8c2891a-4201
12/01/2025
Full time
Description: Position Summary: The Operations Specialist is responsible for supporting the Operations Team through multiple tasks required for the successful support of each region's individual needs. Essential Functions and Job Responsibilities: Supports operations team with discovery and training as necessary with AdaptHealth processes. Responsible for providing support during process improvement initiatives to assist with driving all areas of workflow, including verification, and data analysis. Develop and maintain working knowledge of current products and services offered by the company Must be familiar with payer guidelines and reading clinical documentation to determine qualification status and compliance for all equipment and services. Working knowledge in all areas of AdaptHealth customer service, intake, daily operations and revenue cycle processes and workflows from beginning to end, which may include Review all required documentation to ensure accuracy Accurately process, verify, and/or submit documentation Complete insurance verification to determine patient's eligibility, coverage, co-insurances, and deductibles Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required (if helping a region) Navigate through multiple online EMR systems to obtain applicable documentation Enter and review all pertinent information in EMR system including authorizations and expiration dates Meet quality assurance requirements and other key performance metrics Pays attention to detail and has great organizational skills Actively listens to teams, region leaders and handle stressful situations with compassion and empathy. Ability to analyze data and reports to identify execution errors in workflow, troubleshoot and fix the exceptions, advise staff on corrections. Collaborate with the Operations Team on exceptions and solutions within workflow processes Communicate with operations teams and leadership on an on-going basis regarding any noticed trends in process errors with insurance companies Assist with various projects and tasks as needed for various unique processes Participate in the effort to define, document, and refine processes, procedures and workflows for business operations based on industry and company best-practices. Participate in the effort to create training materials and train client engagement and service teams 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. Competency, Skills and Abilities: Excellent ability to communicate both verbally and in writing Ability to prioritize and manage multiple tasks Proficient computer skills and knowledge of Microsoft Office Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred. Work well independently and as part of a group Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative and work effectively on a team Requirements: Education and Experience Requirements: High School Diploma or equivalency Three (3) years' work related in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry is required. Physical Demands and Work Environment: Work environment will be stressful at times, as overall office activities and work levels fluctuate Must be able to bend, stoop, stretch, stand, and sit for extended periods of time Subject to long periods of sitting and exposure to computer screen Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use Excellent ability to communicate both verbally and in writing Ability to effectively communicate both verbally and written with internal and external customers with the ability to demonstrate empathy, compassion, courtesy, and respect for privacy. Mental alertness to perform the essential functions of position. Compensation details: 19-23 Hourly Wage PI60c7f8c2891a-4201
ROLE OVERVIEW The RCM Specialist II is an individual contributor role on the RCM team, responsible for AR follow-up, posting payments, processing refunds and credits, and auditing accounts accurately. This role supports the full revenue cycle, helping ensure timely resolution of outstanding balances, clean financial records, and a smooth experience for both practices and patients. An ideal candidate has a strong understanding of AR processes, account research, and payer guidelines. They are detail-oriented, analytical, and confident in navigating account-level discrepancies and improving key revenue cycle metrics. KEY RESPONSIBILITIES Perform all assigned RCM activities in accordance with best practices and internal SOPs. Perform AR follow-up to resolve unpaid or underpaid claims, denials, and aged balances through appropriate action (i.e. appeals, corrections, resubmissions, etc.) Audit accounts to verify accurate claim submission, payment application, adjustments, and resolution of outstanding balances. Review and resolve credit balances; process refunds to insurance and patients in compliance with regulations and internal policies. Post all payments - insurance and patient - accurately and in a timely manner, including zero-dollar payments and remittance reconciliations (manual and electronic). Apply adjustments and write-offs appropriately based on payer contracts and internal guidelines. Work AR aging reports regularly to reduce days in AR and the percentage of AR over 90 days. Maintain clear and thorough documentation of account activities, payer interactions, and refund processing steps. Collaborate with internal teams (billing, front office) to ensure clean claims and quick resolution of issues. Maintain compliance with HIPAA, payer guidelines, and internal policies. Participate in team meetings to discuss performance metrics, workflow updates, and process improvements. Support RCM management in understanding and self-identifying contributing factors to site-specific RCM KPIs, highlighting areas of concern and areas for improvement. KPIs include but may not be limited to: Collection Rate: Monitor and report on the net collection rate, analyzing performance against targets. Collaborate with the team to identify opportunities for improvement. Days in AR: Track and evaluate average days in AR to ensure appropriate advanced collection, payment application, efficient and accurate claim filing, and timely back-end billing and claim resolution. Investigate and address any delays or bottlenecks that may be causing extended days in AR. % AR Over 90 Days: Review and analyze the percentage of AR over 90 days (insurance v. patient) to identify trends or issues requiring attention. Work with the team to reduce the percentage of aged receivables by implementing strategies to resolve outstanding claims and payments. Identify trends in rejections, disputes, payment delays, and denials, and escalate issues for resolution. Always seek the root cause to avoid future issues Maintain respect and professionalism in all interactions with internal stakeholders, patients, payers, third parties, and others ESSENTIAL QUALIFICATIONS Prior experience in Dental Office workflows, Revenue Cycle functions to include Scheduling, Registration, Insurance verification, fee schedules, claim submission, charging/coding requirements, insurance AR follow up and payment posting process Must be knowledgeable of reimbursement/compliance process and procedures with all payors Experience with practice management software systems, insurance portals, clearing houses, insurance guidelines, banking reconciliation software, proficient in intermediate PC skills (MS Office-strong excel skills). Strong computer literacy, Excellent Math and problem-solving skills. Data entry and 10-key by touch. Strong interpersonal and organizational skills. Ability to work within a team setting and as an individual contributor. Excellent oral and written communication skills Responsible for quality work, meeting deadlines, and adherence to Compliance and Revenue cycle standard operating procedures Organized work habits, accuracy, and proven attention to detail with strong analytical skills Responsible for quality work, meeting deadlines, and adherence to Compliance and Revenue cycle standard operating procedures Certified Professional Coder (CPC) or Certified Revenue Cycle Professional (CRCP) credentials preferred Compensation details: 22-26 Hourly Wage PI1512ded5-
12/01/2025
Full time
ROLE OVERVIEW The RCM Specialist II is an individual contributor role on the RCM team, responsible for AR follow-up, posting payments, processing refunds and credits, and auditing accounts accurately. This role supports the full revenue cycle, helping ensure timely resolution of outstanding balances, clean financial records, and a smooth experience for both practices and patients. An ideal candidate has a strong understanding of AR processes, account research, and payer guidelines. They are detail-oriented, analytical, and confident in navigating account-level discrepancies and improving key revenue cycle metrics. KEY RESPONSIBILITIES Perform all assigned RCM activities in accordance with best practices and internal SOPs. Perform AR follow-up to resolve unpaid or underpaid claims, denials, and aged balances through appropriate action (i.e. appeals, corrections, resubmissions, etc.) Audit accounts to verify accurate claim submission, payment application, adjustments, and resolution of outstanding balances. Review and resolve credit balances; process refunds to insurance and patients in compliance with regulations and internal policies. Post all payments - insurance and patient - accurately and in a timely manner, including zero-dollar payments and remittance reconciliations (manual and electronic). Apply adjustments and write-offs appropriately based on payer contracts and internal guidelines. Work AR aging reports regularly to reduce days in AR and the percentage of AR over 90 days. Maintain clear and thorough documentation of account activities, payer interactions, and refund processing steps. Collaborate with internal teams (billing, front office) to ensure clean claims and quick resolution of issues. Maintain compliance with HIPAA, payer guidelines, and internal policies. Participate in team meetings to discuss performance metrics, workflow updates, and process improvements. Support RCM management in understanding and self-identifying contributing factors to site-specific RCM KPIs, highlighting areas of concern and areas for improvement. KPIs include but may not be limited to: Collection Rate: Monitor and report on the net collection rate, analyzing performance against targets. Collaborate with the team to identify opportunities for improvement. Days in AR: Track and evaluate average days in AR to ensure appropriate advanced collection, payment application, efficient and accurate claim filing, and timely back-end billing and claim resolution. Investigate and address any delays or bottlenecks that may be causing extended days in AR. % AR Over 90 Days: Review and analyze the percentage of AR over 90 days (insurance v. patient) to identify trends or issues requiring attention. Work with the team to reduce the percentage of aged receivables by implementing strategies to resolve outstanding claims and payments. Identify trends in rejections, disputes, payment delays, and denials, and escalate issues for resolution. Always seek the root cause to avoid future issues Maintain respect and professionalism in all interactions with internal stakeholders, patients, payers, third parties, and others ESSENTIAL QUALIFICATIONS Prior experience in Dental Office workflows, Revenue Cycle functions to include Scheduling, Registration, Insurance verification, fee schedules, claim submission, charging/coding requirements, insurance AR follow up and payment posting process Must be knowledgeable of reimbursement/compliance process and procedures with all payors Experience with practice management software systems, insurance portals, clearing houses, insurance guidelines, banking reconciliation software, proficient in intermediate PC skills (MS Office-strong excel skills). Strong computer literacy, Excellent Math and problem-solving skills. Data entry and 10-key by touch. Strong interpersonal and organizational skills. Ability to work within a team setting and as an individual contributor. Excellent oral and written communication skills Responsible for quality work, meeting deadlines, and adherence to Compliance and Revenue cycle standard operating procedures Organized work habits, accuracy, and proven attention to detail with strong analytical skills Responsible for quality work, meeting deadlines, and adherence to Compliance and Revenue cycle standard operating procedures Certified Professional Coder (CPC) or Certified Revenue Cycle Professional (CRCP) credentials preferred Compensation details: 22-26 Hourly Wage PI1512ded5-
