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

UPMC; Pittsburgh (Allegheny County); Remote; USD 55,000 - 75,000; Full time

Job summary

UPMC Health Plan is seeking a full-time Associate Operations Analyst to support the Medicare HCC Department. This role is home-based with extensive travel across the footprint, traveling up to 2 hours.

The Associate oversees administrative and system processes, identifying and implementing solutions for the transactions system across all products. The ideal candidate has medical office or terminology experience, EMR familiarity, and strong MS Office skills.

Qualifications

• Bachelor's degree or equivalent work experience.
• Minimum two years general business experience.
• Excellent planning, communication, documentation, analytical and problem-solving abilities.
• Experience in health care insurance or health care industry strongly preferred.
• Competence in MS Office including Excel, Access, and Word.

Responsibilities

• Spend 50% of time onsite in offices abstracting medical records via EMR or paper records.
• Identify areas of concern impacting client satisfaction through data analysis and propose solutions.
• Model business requirements for new systems and test fixes/enhancements to systems.
• Participate in team meetings, share ideas, and promote teamwork.
• Complete Executive Summary management documentation as required.
• Prioritize and complete assigned tasks and manage multiple projects.
• Interface with customers by phone, correspondence, and in person to resolve concerns.
• Maintain source data dictionaries related to processes.

Skills

Data analysis

Communication skills

Project management

Interpersonal skills

Analytical thinking

Education

Bachelor's degree or equivalent experience

Tools

MS Office

MS Excel

MS Access

MS Word

EMR systems

Job description

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