Lead, Operations
On-site · Bluefield, Virginia, United States
Job Summary
The Operations-focused Lead, Operations role supports the Operations Team across regions, including delivering and setting up medical equipment as needed. The Lead serves as a subject matter expert, provides new hire training and mentorship, and leads process-improvement initiatives, data analysis, and workflow optimization. Requires strong knowledge of payer guidelines, clinical documentation, EMR systems, insurance verification, pre-authorization processes, and HIPAA compliance. Responsibilities span documenting and reviewing processes, ensuring accuracy in documentation, validating patient eligibility and coverage, and coordinating with insurance and revenue-cycle activities. The role also includes supervising team members, leading meetings and training, monitoring performance metrics, and preparing management-level analyses. Requires ability to navigate multiple EMR systems, deliver patient care equipment when needed, drive as required, maintain PPE and infection-control practices, and participate in on-call duties. Education/experience includes a high school diploma or equivalent (associate degree preferred), valid driver’s license, healthcare administration/insurance experience, and progression through Specialist/Senior/Lead levels with increasing years of experience. Maintains patient confidentiality per HIPAA and adheres to Compliance Program requirements.
Required Qualifications
- High school diploma or equivalent required
- Associate’s degree in healthcare administration, Business Administration, or related field preferred
- Valid and unrestricted driver's license in the state of residence
- Related experience in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry
- Exact job experience is health care organization, pharmacy that routinely bills insurance or provides Diabetics, Medical Supplies, HME, Pharmacy or healthcare (Medicare certified) services
- Specialist Level: One (1) year of work-related experience
- Senior Level: One (1) year of work-related experience plus Two (2) years exact job experience
- Lead Level: One (1) year of work-related experience plus Four (4) years exact job experience
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