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Pittsburgh, Pennsylvania, United States · Hybrid
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The Claims Examiner manages the adjudication of moderate to complex claims while meeting production and quality standards. They also assist other departments during backlogs and participate in team meetings to ensure client satisfaction.
A high school diploma or equivalent is required, with one year of claims processing experience preferred. Candidates must have knowledge of medical terminology, ICD-9, CPT coding, and various insurance products.
UPMC Health Plan has an exciting opportunity for a Claims Examiner position in the TPA CCBH Claims Operations department. This is a full-time hybrid position based in the Pittsburgh area. While you’ll primarily work remotely, you’ll come into the office occasionally depending on departmental needs. The Claims Examiner will manage adjudication of moderate to complex claims while meeting or exceeding production and quality designated standards.
Responsibilities:
UPMC is an Equal Opportunity Employer/Disability/Veteran
Life Changing Medicine.
UPMC is a world-renowned, nonprofit health care provider and insurer committed to delivering exceptional, people-centered care and community services. Headquartered in Pittsburgh and affiliated with the University of Pittsburgh Schools of the Health Sciences, UPMC is shaping the future of health through clinical and technological innovation, research, and education. Dedicated to advancing the well-being of our diverse communities, we provide nearly $2 billion annually in community benefits, more than any other health system in Pennsylvania. Our 100,000 employees — including more than 5,000 physicians — care for patients across more than 40 hospitals and 800 outpatient sites in Pennsylvania, New York, and Maryland, as well as overseas. UPMC Insurance Services covers more than 4 million members, providing the highest-quality care at the most affordable price. To learn more, visit UPMC.com.
Offices: US Steel Tower, 600 Grant Street, Pittsburgh, PA 15219, US
