Job Description

Job Title: Manager, Claims
Job ID: 659713
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Operations
Location: 1650 Metropolitan Street, Pittsburgh PA 15233

Description

Purpose:
Are you a dynamic leader with a strong background in a fast passed environment?  If so, an opportunity as a Claims Manager with UPMC Health Plan may be the perfect fit for you. This position will oversee and manage the Claims Processing department. This role will require management level experience in planning and directing. If this sounds like the ideal next step in your career, apply today!

Responsibilities:
  • Effectively interact with internal and external customers.
  • Maintain designated standards established for handling incoming work.
  • Maintenance of communication with established clients.
  • Manage and direct all activities and special projects.
  • Provide central coordination and control for implementation of new/changed application and systems.
  • Provide leadership and direction through developing and updating procedures, programs, determining appropriate production standards, determining staffing requirements, and training opportunities.
  • Recruit and discharge employees when necessary.
  • Serve as liaison to clients by participating in demonstrations of operations activities to prospective clients.

Qualifications

  • Bachelors Degree preferred. 
  • 5 years of business experience required. 
  • Prior management experience with automated claims processing is mandatory.
  • Knowledge of medical terminology, ICD-9, and CPT coding required. 
  • Knowledge of commercial, Medicaid, and Medicare products. 
  • Competent in MS Office and PC skills. Able to demonstrate organizational, interpersonal, and communication skills. 
  • Maintain designated production and quality standards. 
  • Ability to react to users needs in a timely and efficient manner. 
  • Direct staff with minimal amount of supervision.

Licensure, Certifications, and Clearances:
UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $27.54 to $46.49

Union Position: No

At UPMC, our shared goal is to create a cohesive, positive, experience for our employees, patients, health plan members, and community. If you too are driven by these values, you may be a great fit at UPMC!

QUALITY & SAFETY
DIGNITY & RESPECT
CARING & LISTENING
RESPONSIBILITY & INTEGRITY
EXCELLENCE & INNOVATION

UPMC provides a total rewards package that can help you achieve the goals you have for your career and your personal life. Whether you want to learn a new skill through a training course, reach personal health and wellness targets, become more involved in your community, or follow a career path that provides you with the right experience to be successful, UPMC can help you get to where you want to be.



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