Job Description

Job Title: Verification Processor
Job ID: 97236498
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Claim Intake Ver-Mail SV
Location: 600 Grant St, Pittsburgh PA 15219

Description


Provide for ensuring accuracy of electronically transmitted data for the purpose of releasing batch claims held for review.

Responsibilities:
  • Update data into the Amisys system accurately and efficiently.
  • Verify and correct as necessary claims received through the FormWorks process to include but not be limited to - Individual characters and fields in OCRepair and OCRepCrit, Information contained in KE (Key Entry).
  • Complete UB's and HCFA's in FormWorks for claims unable to process directly via OCR (KFI/Key From Image).
  • Notify the supervisor and/or team leader of any issues that my compromise client satisfaction.
  • Verify electronically received data pre-adjudication.
  • Investigate via Filenet software or EDI (Electronic Data Interchange) Inquiry Screen(s) any flagged claims.
  • Claim hold/Batch error correction
  • Search continuously for improvement opportunities and notifies the supervisor and/or team leader of trends.
  • Maintain a thorough working knowledge of processes for electronically received data;

Qualifications

  • Completion of High school diploma or equivalent.
  • Able to use a QWERTY keyboard;
  • Knowledge of Insurance, Managed Care, or Benefits Administration environment preferred;
  • Prefer competency in MS Office and PC skills.
  • Able to demonstrate organizational, interpersonal, and communication skills.
  • Maintain designated production and quality standards required.
  • Previous mailroom experience is preferred.

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

Salary Range: $14.26 to $22.35 / hour

Union Position: No

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