Review Operations Assistant
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Concurrent Review Ops Assistant responsible for processing Health Plan files and coordinating with healthcare teams for kidney care operations. Assist in member information verification and documentation among various stakeholders.
Responsibilities:
- Assist in processing Health Plan(s) and Contracted Provider(s) daily files and uploads for all acute and post-acute admissions
- Assist with inpatient and concurrent calls to verify and confirm admission and obtain member information
- Assist with monitoring skilled nursing facility discharges
- Create Care Events as needed for new admissions to be followed by the Clinical Review Team
- Request clinical as needed; retrieve and document clinical from our EMR system(s).
- Communicate with the care team and other internal and external stakeholders
- Analyze data and develop reports/presentations
- Ability to multitask and prioritize in a busy work environment
- Maintain safe, secure, and healthy work environment by establishing and following standards and procedures and complying with legal regulations
Requirements:
- High school diploma or GED required
- Minimum of two (2) years of experience analyzing and solving customer problems
- Proven experience working in the health care industry and working with medical terminology
- Firm grasp on administrative processes and organizational policies
- Understanding and appreciation of patient privacy laws, regulations, policies, and procedures.
- Demonstrated customer service and professional communication skills, both written and verbal.
- Organizational and time management skills, with ability to multitask and maintain attention to detail.
- Timely, reliable, and supportive of team goals and outcomes by completing daily tasks.
- Technically savvy when handling video and audio meetings.
- Proficient in Microsoft Office – predominately Excel
Benefits:
- Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts
- Financial & Retirement Support – Competitive compensation, 401k with employer match, and financial wellness resources
- Time Off & Leave – Paid holidays, flexible vacation time/PSSL, and paid parental leave
- Wellness & Growth – Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts
Similar Jobs
Director of Operations
Director of Operations ensuring financial management and compliance for Priorities USA campaigns. Leading organizational efficiency through operations and technology strategies with a focus on progressive values.
Billing Operations Manager
Billing Manager leading end-to-end billing operations at Revenera, ensuring accuracy and compliance in consumption-based billing processes. Requires strong expertise in billing systems and team management.
Senior Title Operations Manager
Operations Manager overseeing nationwide title services for real estate transactions at Stewart. Leading teams, ensuring compliance, and managing operational functions to enhance service delivery.
Fraud Operations Analyst – Contract
Fraud Analyst reviewing suspicious activity and investigating fraud patterns at Shippo. Maintain performance metrics and educate customers on safe shipping practices.
Senior Operational Excellence Advisor
Senior Advisor leading complex programs improving operational performance at The Cigna Group. Collaborating across clinical, technology, and operations teams for meaningful outcomes.
General Manager – Operations
General Manager overseeing operations for Shermco Industries, providing electrical testing and engineering services in Canada. Leading field operations and business performance across multiple locations with substantial travel.
Senior Operations Lead, Performance Management
Sr. Ops Lead in Performance Management at R1, driving strategic performance in healthcare revenue cycle operations. Collaborating across teams and leveraging data for operational excellence.
Director of Operations
Director of Operations at Bowhead managing SIT Group programs with full P&L responsibility. Leading initiatives for client engagement and operational excellence across DoD contracts.
General Manager, Operations
General Manager of Operations leading service territories at Honor, redefining aging care through technology. Managing teams to enhance client experience and operational effectiveness.
Real Estate Operations
Operations Team Member ensuring smooth administrative, leasing, compliance, and reporting operations across manufactured housing communities. Supporting multiple communities with a focus on accuracy and detail.
Licensing Operations Manager
Licensing Operations Manager at LighthouseAI managing client licensing lifecycle and team development. Overseeing portfolio of clients while ensuring compliance and quality in operations.
District Director of Operations
District Director of Operations at Brookdale managing community operations and strategic direction. Leading revenue oversight and ensuring compliance with operational standards across multiple locations.
Strategic Operations Director
Strategic Operations Director at ParentSquare focusing on go-to-market strategy and product operations initiatives. Leading analysis and operational efficiency improvements across the organization.
Manager, Regional Operations
Manager of Regional Operations driving growth and ensuring customer satisfaction in Casinos and Community Gaming Centres in BC. Overseeing complex relationships and maintaining operational standards.
Revenue Specialist II
Patient Account Specialist at DaVita developing relationships with insurance companies to maximize collections. Resolving outstanding patient balances and adhering to healthcare billing standards.
Analyst, Systems – ROPS
Systems Analyst coordinating stakeholders through SDLC for Revenue Operations improvements. Responsible for documenting and translating business needs into technical requirements.
Claims Examiner – Product, Premise & Completed Operations Liability
Claims Examiner analyzing complex liability claims for Sedgwick, a leader in risk and claims administration. Manage claims with innovative customer-facing solutions and ensure timely resolution.
Revenue Specialist I
Revenue Specialist I performing billing and collections for DaVita's revenue operations. Collaborating with teams to enhance patient insurance processes and ensure timely payments.
Vice President, Operations
Vice President leading IKC Operations managing $1.5B medical cost, enhancing patient outcomes, and collaborating with nephrology practices. Driving innovation in kidney healthcare delivery.
Service Operations Specialist
Service Operations Specialist supporting Avantor customers by performing lab work and research protocols. Reporting to the Supervisor of Operation Specialist and collaborating with Lab and Production Services professionals.