Operations Analyst 1

Claritev•New York, NY

8h•$40 - $45

About The Position

The Operations Analyst I supports Clinical Review operations through claim research, workflow distribution, documentation processing, and operational project support. This role plays a key part in ensuring accurate claims handling, maintaining data integrity, and supporting high-volume operational processes.

Requirements

High school diploma or GED required with a minimum of two (2) years of experience in an operations or service-related role such as claims processing, customer service, medical records, collections, data entry, or database management
Associate’s degree may be considered in lieu of experience
Strong communication skills including written, verbal, and active listening
Strong analytical, organizational, and prioritization skills
Proficiency in Microsoft Office, including Word and Excel, and experience with database systems
Ability to manage multiple tasks and adapt quickly in a fast-paced environment
Strong technical aptitude and ability to navigate multiple systems
Ability to identify issues and escalate appropriately
Ability to build trust and credibility across all levels of the organization
Ability to work independently while handling confidential information
Flexibility to adjust schedule as needed to meet business demands

Nice To Haves

Healthcare experience and/or familiarity with medical coding concepts preferred

Responsibilities

Review, investigate, and analyze claim appeals, partnering with coding teams to coordinate documentation review
Support customer service, providers, and clients by resolving claim-related inquiries and issues
Research and manage claim inventory across inpatient, outpatient, and provider billing
Request, track, and process documentation for clinical reviews and special projects
Access and retrieve information from internal systems and external client platforms
Perform data entry and maintain databases, including validation and updates to provider data
Execute system claim adjustments based on appeal outcomes or corrected claims
Manually distribute workflow when system automation is unavailable
Support operational and service-related pilot projects alongside daily responsibilities
Collaborate across departments to ensure alignment and effective communication
Maintain compliance with HIPAA regulations and company policies
Prioritize and manage shifting workloads in a fast-paced environment

Benefits

Medical, dental and vision coverage with low deductible & copay
Life insurance
Short and long-term disability
Paid Parental Leave
401(k) + 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
Flexible Spending Account
Employee Assistance Program
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