Operations Analyst, Associate

UPMC; Alaska; Remote; USD 60,000 - 80,000; Full time

Job summary

UPMC Health Plan seeks an Associate Operations Analyst to support Medicare HCC. This full-time, home-based role requires travel up to 2 hours to sites for record abstraction and onsite work.

The Analyst analyzes processes, develops solutions, and tests system enhancements while supporting multiple departments and ensuring client satisfaction.

Qualifications

• Bachelor's degree or equivalent work experience.
• Minimum two years general business experience.
• Driver's license and reliable form of transportation.
• Experience in health care insurance preferred.
• Previous EMR systems experience is a bonus.

Responsibilities

• Spend 50% of time onsite in offices abstracting medical records via EMR or paper records.
• Identify areas of concern through data analysis and propose solutions.
• Model business requirements for new systems and projects; validate fixes.
• Participate in team meetings and promote teamwork.
• Prepare Executive Summary management documentation as required.
• Follow system-wide competencies/behaviors.
• Participate in training programs when available.
• Prioritize and complete assigned tasks.
• Identify, test, and implement new processes on claims systems.
• Interface with customers by phone, correspondence, or in person.
• Assist other departments during backlogs.
• Maintain source data dictionaries related to processes.
• Complete inquiries from data reporting and analysis area.
• Maintain confidentiality of employee/insured data.

Skills

Microsoft Office

Medical terminology

Data analysis

Education

Bachelor's Degree or equivalent work experience

Tools

EMR systems

Job description

Operations Analyst, Associate (Abstractor) - Allegheny & Westmoreland County Area

UPMC Health Plan is seeking a full-time Operations Analyst, Associate (Abstractor) to support the Medicare HCC Department. This position will be home-based; however, it requires extensive travel throughout the footprint, abstracting medical records physically onsite and in person. The selected candidate must be willing to travel for up to 2 hours.

The Associate Operations Analyst oversees administrative, system processes, and special projects as they relate to the identification, implementation, and maintenance of the claims transactional system for all UPMC Health Plan products. Under the general direction of Business Support Management, this role will analyze, identify, propose, and implement solutions for all business areas. The Associate Operations Analyst acts as a subject matter expert supporting all areas and interacts with staff to answer questions and resolve issues as they arise. The ideal candidate for this position will have previous medical office and/or medical terminology experience, with Electronic Medical Records experience being a plus! Proficient computer and Microsoft Office skills are preferred, as well.

Responsibilities:

• Spend 50% of time physically onsite in offices abstracting medical records via EMR or paper record
• Identify areas of concern that may compromise client satisfaction through data analysis, and propose solutions based on findings, expertise, and research
• Model business requirements for new systems, special projects and enhancements to existing systems; validate and test fixes/enhancements to new and existing systems
• Openly participate in team meetings, provide ideas and suggestions to ensure client satisfaction, and promote teamwork
• Completes Executive Summary management documentation as required
• Performs in accordance with system-wide competencies/behaviors
• Participates in training programs when available/as requested
• Effectively prioritize and complete all assigned tasks
• Identify, administer, test, audit, and implement new processes on transactional claims systems
• Interface with customers by telephone, correspondence, and or in person to answer inquiries and resolve concerns/issues
• Assists other departments during periods of backlogs
• Manages, updates, and maintains source data dictionaries as they relate to processes
• Complete inquiries generated from the data reporting and analysis area
• Maintains employee/insured confidentiality

Bachelor's Degree or equivalent work experience.

• Minimum two years general business experience
• Candidate must have driver's license and reliable form of transportation
• Experience in health care insurance or health care industry is strongly preferred.
• Previous experience in EMR systems is a bonus.
• Knowledge of Commercial, Medicaid, Medicare and Individual products preferred.
• Competence in MS Office required, including MS Excel, MS Access, MS Word.
• Excellent planning communication, documentation, analytical and problem-solving abilities.
• Ability to work in a fast-paced environment.
• Must possess strong interpersonal, organizational, and project management skills, with the ability to work on multiple tasks simultaneously.
• Experience in QA/Audit/Systems testing development and execution preferred.
• Licensure, Certifications, and Clearances: Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran