Job Description

Job Title: Provider Reimbursement Project Coordinator
Job ID: 687332
Status: Full-Time
Regular/Temporary: Regular
Hours: 8:00 a.m. – 4:30 p.m.
Shift: Day Job
Facility: Community Care Behavioral Hlth
Department: Provider Reimbursement
Location: 339 Sixth Avenue, Pittsburgh PA 15222

Description

Do you have at least 5 years’ experience in a claims processing or provider billing operations role? Do you have strong communication skills? If so, UPMC may have the perfect fit for you!

 

 

UPMC is hiring a full-time Provider Reimbursement Project Coordinator to support the Provider Reimbursement department within Community Care Behavioral Health. This is a daylight position (8:00 a.m. - 4:30 p.m.) and will be located in downtown Pittsburgh, PA.  This position will require potential travel within PA and the tri-state area.

 


The Project Coordinator for Claims is responsible for ongoing review of regulatory changes, communication to the management team and update of policies and procedures, related to the claims process. Must understand the claims process from submission to the interpreting back-end claims reports. In addition the Project Coordinator is responsible for managing all new and ongoing projects as determined by the management team. Must be able to travel to provider sites and to regional offices as needed.

Responsibilities:

  • Assist with development and presentation of Provider Claims Training.
  • Attend meetings with providers to instruct in the claim submission process and/or to facilitate the resolution of the provider's claim related issues.
  • Manages key projects as assigned; these may changes from time to time. Maintains a list of current projects to disseminate to internal customers.
  • Monitor and be accountable for high-level provider issues for a specific region or line of business or division of business as determined by the Claims Director.
  • Position can cross HealthChoices regions and Community Care lines of business, except WBH; therefore, the person will have to be able to travel as needed.
  • Provides oversight to link key processes, policies and procedures and quality monitoring.
  • Responsible for researching Claims related complaints and grievances with review by the Claims Director and appropriate Claims Manager.
  • Responsible for understanding and performing job responsibilities consistent with the company's mission statement, values statement, code of conduct and global goals.

Qualifications

  • 5 years experience in a claims processing or provider billing operations required
  • Bachelors degree in a related field preferred
  • Excellent written and verbal communication skills required.
  • Analytical and organizational skills and sense of responsibility required.
  • PC proficiency in a windows environment for word processing and spreadsheet software.

Licensure, Certifications, and Clearances:

  • Automotive Insurance
  • Driver's License

UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $18.24 to $30.32

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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