Olubunmi Bamidele

• Lead daily utilization review processes, ensuring seamless operations across clinical and administrative functions.
• Train and mentor staff on departmental protocols, fostering a culture of continuous improvement.
• Conduct audits to validate medical necessity and compliance, contributing to a significant reduction in claim denials.
• Oversee appeals management and negotiate with insurance providers, achieving high overturn rates.
• Spearhead process improvements to optimize efficiency in patient admission and discharge workflows.

Key Achievements:

• Designed training programs that enhanced clinical documentation accuracy, improving compliance rates.
• Implemented efficient denial management practices, achieving a 20% improvement in claim processing times.
• Achieved Lean Six Sigma Yellow Belt certificate to drive process improvement initiatives.

• Assessed and documented patient cases to ensure compliance with insurance policies and medical necessity standards.
• Facilitated discharge planning by coordinating with the Social Services Department and care providers.
• Provided detailed reporting and analysis to the Utilization Review Committee, enabling informed decision-making.

Key Achievements:

• Streamlined admissions and continued-stay reviews, ensuring compliance with regulatory standards.
• Strengthened communication with insurance providers, reducing delays in service delivery.

• Directed admissions and intake processes for specialty programs, ensuring operational efficiency.
• Cultivated long-term relationships with referral sources to streamline patient transfers and admissions.
• Delivered clinical triage services, ensuring timely and appropriate patient care.

Key Achievements:

• Led the implementation of Allscripts Patient Flow, enhancing patient tracking and admissions efficiency.
• Conducted staff training sessions, improving team productivity and readiness.