Operation Specialist
: Job Details :

Including but not limited to: - Oversees all departmental work schedules for each colleague. Ensures appropriate coverage and escalates issues to the manager. - Assists Utilization Managers with all aspects of utilization review/discharge planning/performance improvement processes. - Functions as liaison for all electronic platforms including Interqual, Rightfax, NaviHealth, Change Healthcare, Epic, etc. - Manages all utilization management work queues by researching and following up on all individual issues as well as identified trends in the data. - Partners with LHSS or BILH as needed for elements requiring involvement of hospital billing, Admissions, ADT, denial management, and corrections to accounts. - - Escalates unresolved or concerning issues regarding documentation, quality, billing, denials, or anything else related to departmental operations to the appropriate person for resolution. - Contributes to a high integrity operation by ensuring the documentation is processed in li...Specialist, Operation, Clinic, Operations, Healthcare