Operations Analyst, Associate (Central PA)

UPMC; Pennsylvania; Hybrid; USD 50,000 - 80,000; Full time

Job summary

An established industry player is seeking a full-time Operations Analyst, Associate to support the Medicare HCC Department. This role is pivotal in overseeing administrative processes and implementing solutions across various business areas. The selected candidate will work primarily from home but must be willing to travel for onsite record abstraction. Ideal candidates will possess a blend of medical office experience and data analysis skills, ensuring client satisfaction through effective communication and problem-solving. Join a dynamic team where your contributions will directly impact operational excellence and patient care.

Qualifications

• Experience in a medical office setting is preferred.
• Knowledge of electronic medical records is a plus.

Responsibilities

• Spend 50% of time onsite abstracting medical records.
• Analyze data to propose solutions for client satisfaction.
• Participate in team meetings and provide suggestions.

Skills

Medical Office Experience

Medical Terminology

Electronic Medical Records (EMR)

Data Analysis

Microsoft Office Proficiency

Education

Bachelor's Degree in a related field

Job description

UPMC Health Plan - Operations Analyst, Associate

UPMC Health Plan is seeking a full-time Operations Analyst, Associate to support the Medicare HCC Department. This position will support operations in Central Pennsylvania. The candidate selected for this role must live in/around this area. This position will be home-based, however, it requires extensive travel throughout the footprint, including abstracting medical records physically onsite and in person. The selected candidate must be willing to travel up to 2 hours.

The Associate Operations Analyst oversees administrative, system processes, and special projects related 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 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.

Responsibilities:

1. Spend 50% of time physically onsite in offices abstracting medical records via EMR or paper record.
2. Identify areas of concern that may compromise client satisfaction through data analysis, and propose solutions based on findings, expertise, and research.
3. Model business requirements for new systems, special projects, and enhancements to existing systems; validate and test fixes/enhancements to new and existing systems.
4. Participate actively in team meetings, provide ideas and suggestions to ensure client satisfaction, and promote teamwork.
5. Complete Executive Summary management documentation as required.
6. Perform in accordance with system-wide competencies and behaviors.
7. Participate in training programs when available or as requested.
8. Prioritize and complete all assigned tasks effectively.
9. Identify, administer, test, audit, and implement new processes on transactional claims systems.
10. Interface with customers via telephone, correspondence, or in person to answer inquiries and resolve concerns/issues.
11. Perform other duties as assigned.
12. Assist other departments during periods of backlogs.
13. Manage, update, and maintain source data dictionaries related to processes.
14. Complete inquiries generated from data reporting and analysis areas.
15. Maintain employee and insured confidentiality.