COVID-19 Vaccination Information

Across UPMC, our guiding principle is to always prioritize the safety of our employees, patients, and members. UPMC believes that vaccination is important, helps protect all, and advocates that everyone who can be vaccinated should be vaccinated.

UPMC complies with all governmental requirements related to local, state, and federal COVID-19 vaccination for employment. The Jan. 13 Supreme Court of the United States decision that the Centers for Medicare & Medicaid Services federal COVID-19 vaccine mandate will move forward requires UPMC to ensure employees either get vaccinated or receive a requested medical or religious exemption.

If you are not yet vaccinated, we urge you to get a vaccine now. You can schedule your COVID-19 vaccination through UPMC or visit a non-UPMC provider or UPMC Urgent Care location.

Proof of vaccination is not required upon hire; however, employees will be responsible for ensuring post-hire compliance by getting vaccinated or requesting a medical or religious exemption.

For more information about UPMC’s response to COVID-19, please visit UPMC.com/coronavirus.

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   Current UPMC employees must apply in HR Direct

Team Leader, Claims

Description


Provide technical and plan support to claims examiners and adjustment/COB staff. Assist with the development and training of team members. Process VIP claims and adjustments. Resolve customer concerns as needed. Assume supervisory responsibility as necessary.

This is a hybrid position. Travel in the office will be required upon request. 

Responsibilities:

  • Research and respond to both external and internal inquiries in a timely manner.
  • Perform system demonstrations for prospective/existing clients.
  • Process claims and/or adjustments.
  • Complete special projects as assigned.
  • Maintain employee and insured confidentiality.
  • Assume supervisory responsibility in the absence of the supervisor.
  • Identify and participate in the training needs of team members.
  • Assist other departments as requested during periods of backlogs.
  • Provide technical support to team members.
  • Participate in the development/refinement of policies and procedures.
  • Support cross-functional team members to meet or exceed quality and production designated standards.
  • Assist with inventory control measures.

 

Qualifications

  • Bachelor's degree or equivalent experience
  • Minimum of five years of health insurance, medical claims processing, claim adjustment; coordination of benefits, and/or customer service experience required;
  • 3 years of experience in managed care, benefit administration, PPO, HMO, Medicare, Medicaid, and coordination of benefits, third-party liability claim adjudication/adjustments preferred
  • Knowledge of Medical Terminology, ICD-10, and CPT coding required
  • Competent in MS Office and PC skills.Ability to demonstrate organizational, interpersonal, and communication skills.


Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

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More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life — because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

   Current UPMC employees must apply in HR Direct

Security Alert

We are aware of scams targeting UPMC and other large companies that involve individuals posing as employees to illegitimately conduct interviews and extend false employment offers and payments to gain access to candidates' personal information. Please note that UPMC will not communicate with candidates through third-party email services like Gmail or Yahoo. While some interviews may take place via a video conferencing service, UPMC Talent Acquisition will not conduct interviews via Skype or Google Hangouts. UPMC will never ask for or disburse funds during the recruitment process. If you are hired into a role with a sign-on bonus or similar incentive, funds will be paid to you by UPMC after your start date.

If you suspect you have been a victim of a fraudulent UPMC job offer, please report the attempt using this form.