Order Entry Specialist

Position Summary:

The Order Entry Specialist is responsible for accurately entering patient order data into electronic health record systems and maintaining compliance with healthcare regulations and organizational policies. This position ensures timely and precise processing of patient orders while maintaining confidentiality standards.

The lead specialist serves as a subject matter expert, conducts new hire training and mentor to the team. 

Essential Functions and Job Responsibilities:

Data Entry and Processing

• Enter patient order information into electronic health record (EHR) systems and order management databases
• Process medical supply requests and prescription orders
• Verify accuracy and completeness of patient demographics, insurance information, and clinical data
• Review physician orders for completeness and clarity prior to system entry
• Document all order entries, modifications, and corrections in appropriate systems

Quality Control and Compliance

• Ensure data entry compliance with HIPAA regulations and organizational policies
• Perform accuracy checks on entered data to maintain system integrity
• Follow established protocols for processing urgent and routine patient orders
• Maintain strict patient confidentiality standards
• Participate in quality assurance audits and improvement processes

Communication and Coordination

• Communicate with healthcare providers, clinical staff, and administrative personnel regarding order clarifications
• Contact insurance providers for coverage verification and prior authorization processes
• Respond to status inquiries regarding order processing and completion
• Escalate complex orders to supervisory or clinical staff as appropriate

Administrative Functions

• Maintain electronic and physical filing systems for order documentation
• Generate reports on processing metrics, turnaround times, and productivity measures
• Assist in training activities for new personnel on order entry procedures
• Stay current with system updates, policy revisions, and regulatory changes
• Lead Responsibilities:
• Supervise and provide guidance to team members in daily operations and complex case resolution
• Lead team meetings and facilitate training sessions for staff development
• Monitor team performance metrics and productivity standards, providing feedback and coaching as needed
• Serve as primary escalation point for difficult customer issues and complex regulatory compliance questions
• Develop and implement process improvements and workflow optimization strategies
• Coordinate with management on staffing needs, scheduling, and resource allocation
• Conduct new employee onboarding and ongoing training programs
• Maintain advanced expertise in Medicare guidelines, payer policies, and regulatory changes to guide team decisions
• Prepare reports and analysis on team performance, trends, and operational metrics for management review
• Maintains patient confidentiality and functions within the guidelines of HIPAA.
• Completes assigned compliance training and other education programs as required.
• Maintains compliance with AdaptHealth's Compliance Program.
• Performs other related duties as assigned.

Competency, Skills, and Abilities:

• Proficiency with computer systems and database applications
• Understanding of basic medical terminology
• Knowledge of insurance verification processes
• Strong attention to detail and organizational skills
• Ability to work under time constraints and manage multiple priorities
• Written and verbal communication skills
• Professional demeanor in patient and staff interactions
• Commitment to confidentiality and data security protocols
• Experience with major EHR platforms (Epic, Cerner, Allscripts)

Education and Experience Requirements:

• High school diploma or equivalent required; Associate’s degree in healthcare administration, Business Administration, or related field preferred
• 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: (Entry 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

Physical Demands and Work Environment:

• Extended sitting at computer workstations with repetitive keyboard use; occasional standing, bending, and lifting to 10 pounds.
• Office environment with computer workstation
• Fast-paced healthcare setting with competing priorities
• Standard business hours with occasional overtime requirements
• Exposure to confidential patient information
• Proficiency with computers, office equipment, payer portal systems, and healthcare software applications
• Sustained concentration, diligence, and ability to manage confidential patient and insurance information with discretion.
• Professional verbal and written communication skills 
• Ability to work independently with minimal supervision and availability for extended hours when required.