Job Description

Job Title: Claims Payable Analyst, Associate
Job ID: 681804
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Evolent Admin
Location: 600 Grant St, Pittsburgh PA 15219

Description

The function of the Associate Claims Payable Analyst is to ensure all Claims Payable Reports, Billing, Payables and Funding are completed accurately and timely. This includes, but is not limited to, funding, payables, billing, refund adjustments, check voids, negative balance reporting and adjustments, and subrogation adjustments. They will work closely with their Supervisor and Management to maintain efficient production within the department and assist in identifying and resolving issues in a proactive and timely manner. They will handle minimal reconciliation issues and interact with other departments on resolving issues. Their role may involve system testing and working with internal/external auditors.

Responsibilities:
  • Adjust claims to reflect refunded checks and voided checks, including subrogation adjustments.
  • Assist in internal/external audits.
  • Assist project teams and workgroups.
  • Gain an understanding of all Claims Payable/Billing processes.
  • Interface with internal and external customers to assure resolution of inquiries and concerns.
  • Perform any other duties as assigned. Performs in accordance with system-wide competencies/behaviors. Learns and adheres to policies and procedures.
  • Update vendor bank files for EFT payments and ACH processing.
  • Update vendor files based on W-9 form sent in by providers.
  • Work cut logs and return mail.

Qualifications

  • Minimum of a High School diploma or GED. 
  • Bachelor's Degree in Business Administration- Accounting, Finance or related field preferred. 
  • Insurance claims and/or claims payable billing experience preferred. 
  • Competency in utilizing and understanding an integrated operating system is required. 
  • Demonstrate professionalism, enthusiasm and initiative daily, as well as the ability to handle multiple tasks. 
  • Excellent communication and organization skills with the ability to represent the department on workgroups and/or projects. 
  • Excellent understanding of health insurance products. 
  • Competency in Excel and Word experience required.
  • Previous healthcare or health insurance experience is strongly preferred.
  • Bachelor's degree or one year of insurance claims and/or billing experience is preferred.

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

Salary Range: $14.53 to $22.86

Union Position: No

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