At UPMC, we are committed to keeping our community safe and healthy as the COVID-19 pandemic unfolds. As our team continues to provide Life Changing Medicine to our patients, our recruiters will continue to fill positions throughout this time. Interviews and other processes may be modified to protect the safety of our candidates and employees. Thank you for your patience.

For more information about UPMC's response to COVID-19, please visit

Job Description

Job Title: Team Leader, Claims
Job ID: 34434846
Status: Full-Time
Regular/Temporary: Regular
Shift: Day Job
Facility: UPMC Health Plan
Department: Operations
Location: 1650 Metropolitan Street, Pittsburgh PA 15233


Provide technical and plan support to claims examiners and non-par provider specialist staff. Assist with development and training of team members. Process VIP claims and adjustments. Resolve customer concerns as needed. Assume supervisory responsibility as necessary.


  • 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.



  • 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

Salary Range: $20.71 to $34.54 / hour

Union Position: No

Apply Current Employee?


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!


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.


Now more than ever, YOU can help us shape our communities and UPMC into a better place for everyone to work, study, play, and thrive.

Learn more about working here and check out our policies and recent updates.

UPMC Health Plan Named Best Places to Work for LGBTQ Equality in 2020

UPMC Ranked #1 Best Places for Women and Diverse Managers in 2019

Talent Network