At UPMC, we are committed to keeping our communities safe and healthy as the COVID-19 pandemic unfolds. Visit upmc.com/vaccinesupport to learn more about how you can help.

Our recruiters will continue to fill positions throughout this time, but 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 upmc.com/coronavirus.

Search Our Jobs

   Current UPMC employees must apply in HR Direct

Complaints and Grievances Intake Coordinator- Temporary

Description

UPMC Health Plan is hiring a temporary Complaints and Grievances Intake Coordinator to help support the Complaints and Grievances Department for its downtown Pittsburgh location at the US Steel Tower. This is a Monday through Friday daylight position.

The successful candidate will manage accurate and timely case entry and classification in the Complaints and Grievances (C&G) information system. Accurately maintain C&G data files.

Responsibilities:
  • Respond and address incoming messages via department inboxes, emails, faxes, or phone in an accurate and prompt manner.
  • Complete data entry into various information systems to support C&G processes.
  • Conduct case intake process, via cases received through verbal and written requests, and set up new cases in the C&G information system.
  • Accurately and promptly assess, enter and maintain documents in files and/or databases to assure that information is organized and readily available.
  • Identify and escalate priority and expedited issues to management within a timely manner.
  • Access multiple health plan systems to assist with case classification.
  • Retrieve, copy, collate, and file various documents associated with the complaints and grievances processes.
  • Classify member and provider complaints/appeals based on line of business and appeal rights by completing appropriate investigation with may include outbound contact, as needed.
  • Triage and respond to inquiries as appropriate or distribute as needed.
  • Support the team's efforts to improve performance against measured service operation goals.
  • Support implementation of appeals tracking system

Qualifications

  • High school graduate or equivalent required
  • 2 year of work experience in claims or customer service preferred, 5 years preferred
  • Managed care or health insurance experience preferred.
  • Proficiency in typing required
  • Excellent communication, organizational, and customer services skills
  • Detail-oriented
  • Knowledge with Microsoft Word and Excel
  • Demonstrate a positive and professional attitude at all times
  • Problem solving and decision making skills with a solid understanding of managed care principles
  • Knowledge of all product lines

  • Licensure, Certifications, and Clearances:

    UPMC is an Equal Opportunity Employer/Disability/Veteran

    Licensure, Certifications, and Clearances:

    UPMC is an Equal Opportunity Employer/Disability/Veteran

    Total Rewards

    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