Description
UPMC Community Care Behavioral Health is seeking a full-time Operations Analyst, Associate to support the Provider Reimbursement Department at the Heinz 57 Center in Downtown Pittsburgh!
The Operations Analyst will work daylight hours, Monday through Friday, in a flexible hybrid work structure combining in-office and work-from-home days!
The Operations Analyst, Associate oversees administrative functions, system processes, and special projects relating to the identification, implementation, and maintenance of the claims transactional system for the Provider Reimbursement team. This role will analyze, identify, propose, and implement solutions, and will act as a subject matter expert in their area. Additionally, the Operations Analyst will train providers on claim submittals, on navigating the billing website, and will provide technical support for their assigned area, interacting with staff to answer questions and resolve issues as they arise.
Responsibilities:
- 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, validating and testing fixes/enhancements to new and existing systems.
- Openly participate in team meetings, provide ideas and suggestions to ensure client satisfaction, and promote teamwork.
- Complete Executive Summary management documentation, as required.
- Perform in accordance with system-wide competencies/behaviors.
- Participate 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.
- Perform other duties, as assigned.
- Assist other departments during periods of backlogs.
- Manage, update, and maintain source data dictionaries as they relate to processes.
- Complete inquiries generated from the data reporting and analysis area.
- Maintain confidentiality.
Qualifications
- Bachelor's Degree OR equivalent work experience.
- Minimum of two years of general business experience.
- Experience in healthcare insurance or healthcare industry preferred, but those with relevant experience in other industries will be considered.
- Previous experience with billing and claims preferred.
- Knowledge of Commercial, Medicaid, Medicare, and/or Individual products preferred.
- Competence in MS Office required, including Excel, Access, and 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
Total Rewards
More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life — because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.
Our Values
At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.
