External Medical Abstraction Operations Analyst, Associate

in Pittsburgh, PA

External Medical Abstraction Operations Analyst, Associate Job

Job Description Job Attributes+

  • Job ID

    17938664

  • Req #

    4827407

  • Organization

    UPMC Health Plan

  • Department

    MEDICARE HCC

  • Job Category

    Other

  • Job Location

    600 Grant St, Pittsburgh, PA 15219, US

  • Job Type

    Full-Time - Regular

  • Shift

    Day Job

  • Salary

    21.22 - 36.63 / HOUR

  • Remote

    No

Description

UPMC Health Plan has an exciting opportunity for an External Medical Abstraction Operations Analyst, Associate in its Medicare Risk Adjustment department. Although based out of the U.S. Steel Tower in downtown Pittsburgh, the ideal candidate would live within a 20-30 mile radius southeast of Pittsburgh. The candidate would travel to the assigned locations regularly and after a minimum of one year, would be permitted to work from home when not at those assigned locations. The assigned area includes, but is not limited to, parts of southern Allegheny, northeast Washington, and western Westmoreland counties.  

This position is responsible for supporting Risk Adjustment, Quality Improvement, and Organizational Initiatives through onsite and offsite medical record abstraction. The Abstractor will locate, retrieve, and upload appropriate medical records from providers in their assigned area into the collection tool. This position requires active communication and building relationships with contacts in hospitals and practices. The ideal candidate is a highly organized, professional, and self-directed individual.

Responsibilities:

  • 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.

  • Performs in accordance with system-wide competencies/behaviors.

  • Participates in training programs when available/as requested.

  • Effectively prioritize and complete all assigned tasks.

  • Performs other duties as assigned.

  • Assists other departments during periods of backlogs.

  • Maintains employee/insured confidentiality.

  • Schedule and visit assigned provider locations within designated area.

  • Develop positive working relationships with providers, nursing and administrative staff while on-site.

  • Assist with training new hires through ride-alongs and on the job training sessions.

  • Abstract health information from patients’ paper or electronic medical charts.

  • Enter abstracted data into the standard data collection tool.

  • Update the Provider Information database following each visit.

  • Assists with administrative tasks and any other tasks assigned.

  • Performs other job duties as required by manager/supervisor.

  • Meet deadlines and turnaround times set by department manager and director.

  • Communicate, collaborate with the Risk Adjustment team.


Qualifications

  • Bachelor's Degree or equivalent work experience.
  • Minimum two years general business experience.
  • Experience in health care insurance or health care industry preferred, but those with relevant experience in other industries will be considered.
  • Knowledge of Commercial, Medicaid, Medicare and Individual products preferred.
  • Competence in MS Office required, including MSExcel, MSAccess, MSWord.
  • 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.

    Licensure, Certifications, and Clearances:

    UPMC is an Equal Opportunity Employer/Disability/Veteran

Additional Information

Who We Are

<p>At UPMC, we're all here for the same reason - to provide outstanding care. From nursing to finance, pharmacy to software development, each of us contributes in our own way, in our own career path. </p><p>We encourage growth through leadership development, skill building, and continuing education, so that employees can explore their interests and define their careers, while always playing a part in life changing medicine. And, while our opportunities vary, we remain united by the same values across our system:
</p><ul><li>Quality &amp; Safety</li><li>Dignity &amp; Respect</li><li>Caring &amp; Listening</li><li>Responsibility &amp; Integrity</li><li>Excellence &amp; Innovation
</li></ul><p>If you too are driven by these values, we’re ready for you. Find your ideal job at UPMC today!</p>

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