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Out of Network Analyst
Job
MultiPlan
Naperville Park District, IL (In Person)
Full-Time
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Job Description
at MultiPlan in Naperville, Illinois, United States Job Description At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple
- we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders
- internal and external
- driving us to consistently exceed expectations.
JOB SUMMARY
An OON Analyst is essential for ensuring a company's daily operations run smoothly and efficiently. Their role involves a range of tasks, including managing workflow distribution, claim reassignment, data tracking, daily reporting, and maintaining standard spreadsheets. They also provide support and oversight to various departmental queues. Serving as a key link between departments, the OON Analyst plays a pivotal role in achieving the organization's operational goals and promoting growth.JOB ROLES AND RESPONSIBILITIES
1. Operational Documentation and Consistency- Design and maintain clear operational guides to ensure consistent processes.
- Assist in coordinating day-to-day operations to ensure effective and efficient delivery service. 2. Workflow and Claims Management
- Manage manual distribution of claims or workflow when automated systems are unavailable.
- Track the completion and outcomes of assigned tasks within the team.
- Investigate queue and reporting workflows for efficiency improvements and distribution opportunities.
- Manage schedules, meetings, and communications, ensuring proper documentation and timely follow-ups. 3. Data Analysis and Reporting
- Research historical performance to provide analytics on team outcomes.
- Maintain departmental reports to increase claim monetization, improve quality, and identify revenue opportunities.
- Analyze and maintain departmental reports to improve data quality, identify distribution opportunities, and manage workflow.
- Provide ad hoc reports upon request. 4. Process Improvement
- Observe and analyze processes to identify inefficiencies and suggest improvements.
- Recommend changes to systems and operations to optimize workflow efficiency.
- Support project planning, track progress, and ensure deadlines are met, working closely with cross-functional teams.
- Investigate queue and reporting workflows for efficiency improvements and distribution opportunities.
- Assist with special projects, prioritizing and shifting focus as needed while maintaining daily workload. 5. Collaboration and Communication
- Work closely with managers and coordinate with team leaders, and department heads to manage inventory and maintain distribution levels.
- Facilitate feedback from team members and management and executive teams.
- Present solutions and recommendations to management regularly.
- Collaborate with management and executives to set departmental and organizational goals. 6. Issue Resolution and Internal Service
- Assist peers and department heads in resolving issues or inquiries.
- Assist with team inquiries and resolve operational issues to ensure department satisfaction.
- Deliver reports to management and executives, providing insights into operational efficiency. 7. Training and Peer Support
- Train peers on established processes as needed.
- Back up daily workflows for peers when required.
- Support project planning, track progress, and ensure deadlines are met by working closely with cross-functional teams. 8. Operational Oversight and Efficiency Improvement
- Observe, review, and analyze processes to identify inefficiencies and areas for improvement.
- Recommend changes to systems and operations to improve workflow efficiency within the department.
- Maintain accurate records, monitor performance metrics, and prepare operational reports for management. 9. Compliance and Safety
- Demonstrate the company's core competencies and values in all activities.
- Handle sensitive data responsibly due to the high-risk nature of the role.
- Assist with other duties, responsibilities, and qualifications as assigned.
- Ensure compliance with HIPAA regulations, company policies, and industry standards.
- Ensure all operations conform to local,.