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Claims Operations Analyst

Req #:  144282
Facility:  Advocate Physician Partners
Department:  Information Systems
City:  Rolling Meadows
Posting Budget Status:  Day
Shift Type:  Full Time - Permanent
Posting FTE:  1

Associate Referral Amount:  $300.00 
TITLE: Claims Operations Analyst
DEPT:  Customer Service/Claims
LOCATION: Rolling Meadows
SHIFT: Days
FTE: Full-time 1.0

 

Position Requirements:
~ Associates Degree
~ 8 plus years experience in a managed care environment with additional experience in a physician or medical group practice, and/or experience with claim processing.
~ ability to create and manipulate complex Access database. ~Demonstrates excellent organization and problem solving skills.
~demonstrates excellent written and verbal skills.
~Demonstrates the ability to problem solve and works well in a team environment.
~Must posses strong personal computer and database design and analytical skills, along with proficiency with Microsoft Programs and Applications (Excel, Word, Access, Power Point, SQL) as well as Paradox, Resource Information Management Systems (RIMS) and SFTP software. Not Required. Ability to use personal computer for extensive periods of time
Travel in local or out of town conferences as needed
Participation in publications and presentations as requested


Purpose:
The Claims Operations Analyst has overall responsibility for the database management processes and files which impact reporting for Advocate Health Partners Operations. Such database reside in the Claims Operations area, but may also include certain databases maintained in other department which impact claims and financial reporting. This position requires a thorough understanding of Claims related processes and database user needs. This position also supports a variety of Director and Manager level positions by organizing and analyzing large data sets. An important responsibility of this position includes oversight of the database for all claims reporting and an understanding of SQL warehouse fields. This position should have a strong SQL reporting services and business intelligence skills.

Accountabilities:
Provides analytical, technical and problem resolution assistance.
Responsible for overseeing database management processes and files impacting claims/financial reporting. Such responsibilities include processes related to the creation, maintenance, and enhancement of end~user databases for us in the day~to~day operations of various departments.
Serves as the primary liaison to department heads for finance, recovery, claims, eligibility, quality, contracting and medical services in providing financial database information and coordinating database design modifications based on user needs. Interacts with above described departments to automate processes and design databases necessary to produce information as it relates to financial performance. Prepares technical reports and other documentation related to the establishment and functioning of operating databases and systems. Implements workflow changes based on assessments of data handling systems.
Organizes, configures, and analyzes large data sets to determine financial trends. Provides financial analytical support to the Medical Economics function. Provides data and other support requested by the PHO Directors. Utilizes financial and practice management reporting systems. Identifying core financial operations issues through variance, trending, and drill down analyses of data.


Nearest Major Market: Chicago