PAP Specialist

Description

The PAP Specialist manages accurate data entry, inventory and service selection, referral source communication, and technology use to document patient information. This role ensures customers receive PAP equipment by scheduling pickup appointments, providing usage instruction, and explaining and collecting financial responsibility. The PAP Specialist also prepares and submits audit paperwork for Medicare and other insurance claims, responding to audits with communication and process changes that improve daily operations. Additionally, this role monitors and manages PAP device clients, encouraging ongoing compliance with equipment and program requirements.

• Develop and maintain working knowledge of current HME products and services offered by the company and all applicable insurance guidelines respecting eligibility for coverage and reimbursement.
• Is actively involved in team activities, evidenced by participation, mentoring, and training with co-workers
• Assists in the development and maintenance of reference materials for use by staff and facilitates the sharing of information
• Develops relationships with branches, other teams to accomplish goals
• Participates in monthly team meetings and trainings
• Responsible for entering data in an accurate manner, into database including although not limited to payer, authorization requirements, coverage limitations and status of any requalification
• Collaborates with physician offices, AdaptHealth sales and support staff to ensure timely receipt of documentation as well as educating, as necessary.
• Identify trends and providing feedback and education to internal and external customers on compliant documentation requirements for services provided.
• 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
• Other duties as assigned.

• 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 conducted Background Check is required for all roles
• Company conducted Motor Vehicle Record Check is required for driving roles
• Clinical roles require valid licensure/certification, where applicable