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Job Requirements of Operations Analyst I:
JOB REQUIREMENTS (Education, Experience, and Training):
* Minimum high school diploma or GED along with two (2) years' of experience in an operations and/or service role such as claims processing, customer service, medical records, collections, data entry, or database management. Associate's degree accepted without prior experience.
* Experience in health care and/or knowledge of commonly used medical coding preferred.
* Required licensures, professional certifications, and/or Board certifications as applicable
* Communication (written, verbal and listening), analytical, organizational, prioritization, technical, etiquette and interpersonal skills
* Ability to use software and hardware peripherals related to job responsibilities including MS Office Suites with preferred proficiency with Word, Excel, and other database software.
* Ability to be flexible in quickly shifting priorities and keeping up with changes across multiple tasks in a fast paced environment while maintaining a positive and cooperative demeanor.
* Ability to demonstrate strong technical skills.
* Ability to identify issues and escalate for course of action for resolution.
* Ability to elicit trust and credibility with all levels of the organization.
* Ability to adjust/alter schedule to meet deadlines.
* Ability to work independently and handle confidential information.
* Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone
The salary range for this position is $19-23/hr. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.
BENEFITS
We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.
Your benefits will include:
- Medical (PPO & HDHP), dental and vision coverage
- Pre-tax Savings Account (FSA & HSA)
- Life & Disability Insurance
- Paid Parental Leave
- 401(k) company match
- Employee Stock Purchase Plan
- Generous Paid Time Off – accrued based on years of service
- WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service
- 10 paid company holidays
- Tuition reimbursement
- Employee Assistance Program
- Summer Hours
- Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits
EEO STATEMENT
Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please
.APPLICATION DEADLINE
We will generally accept applications for at least 15 calendar days from the posting date or as long as the job remains posted.
#LI-AS1
Do you meet the requirements for this job?
Operations Analyst I
Imagine a workplace that encourages you to interpret, innovate and inspire. Our employees do just that by helping healthcare payers manage the cost of care, improve competitiveness and inspire positive change. You can be part of an established company with a 40-year legacy that helps our customers thrive by interpreting our client's needs and tailoring innovative healthcare cost management solutions.
Our commitment to diversity, inclusion and belonging are part of the fabric of our company. We strive to create a workplace that fosters mutual respect and collaboration, where every talent individual can participate and perform their best work. We are MultiPlan and we are where bright people come to shine!
This position assists with workflow distribution, claim research, documentation processing, and operational/service pilot projects in support of MARS Clinical Review operations.
JOB ROLES AND RESPONSIBILITIES:
1. Review, investigate, and analyze claim appeals, working closely with coders to coordinate review of documentation. Assist customer service, providers, and clients on resolution of issues or inquires.
2. Research and manage claim inventory for inpatient, outpatient, and provider billing using review guidance supplied by our clinical teams.
3. Request and process documentation associated with special projects and clinical review inquiries.
4. Access, research, and retrieve information and documentation from MultiPlan and one of various external client systems.
5. Data Entry and database maintenance including review, validation, and maintenance of provider data.
6. Perform system claim adjustments based on appeal outcomes or to process corrected claims.
7. Manage manual distribution of workflow when system is unable to assign.
8. Assist with special projects as assigned in conjunction with daily workload; prioritizing and shifting focus as needed
9. Collaborate, coordinate, and communicate across disciplines and departments.
10. Ensure compliance with HIPAA regulations and requirements.
11. Demonstrate Company's Core Competencies and values held within.
12. Please note: due to the exposure of PHI sensitive data, this role is considered to be a High Risk Role.
13. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
JOB SCOPE:
This position works independently under general supervision to complete the outlined job responsibilities by applying knowledge of claims and department processes. Work involves applying advanced skills using systems and tools in support of MARS operations. Duties and tasks are focused internally on high volume processes. The incumbent resolves routine questions and issues while referring more complex issues to higher levels for resolution.
Job Requirements:
JOB REQUIREMENTS (Education, Experience, and Training):
* Minimum high school diploma or GED along with two (2) years' of experience in an operations and/or service role such as claims processing, customer service, medical records, collections, data entry, or database management. Associate's degree accepted without prior experience.
* Experience in health care and/or knowledge of commonly used medical coding preferred.
* Required licensures, professional certifications, and/or Board certifications as applicable
* Communication (written, verbal and listening), analytical, organizational, prioritization, technical, etiquette and interpersonal skills
* Ability to use software and hardware peripherals related to job responsibilities including MS Office Suites with preferred proficiency with Word, Excel, and other database software.
* Ability to be flexible in quickly shifting priorities and keeping up with changes across multiple tasks in a fast paced environment while maintaining a positive and cooperative demeanor.
* Ability to demonstrate strong technical skills.
* Ability to identify issues and escalate for course of action for resolution.
* Ability to elicit trust and credibility with all levels of the organization.
* Ability to adjust/alter schedule to meet deadlines.
* Ability to work independently and handle confidential information.
* Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone
The salary range for this position is $19-23/hr. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.
BENEFITS
We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.
Your benefits will include:
- Medical (PPO & HDHP), dental and vision coverage
- Pre-tax Savings Account (FSA & HSA)
- Life & Disability Insurance
- Paid Parental Leave
- 401(k) company match
- Employee Stock Purchase Plan
- Generous Paid Time Off – accrued based on years of service
- WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service
- 10 paid company holidays
- Tuition reimbursement
- Employee Assistance Program
- Summer Hours
- Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits
EEO STATEMENT
Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please
.APPLICATION DEADLINE
We will generally accept applications for at least 15 calendar days from the posting date or as long as the job remains posted.
#LI-AS1