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Provider Reimbursement Project Coordinator

  • Job ID: 971622324
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: Community Care Behavioral Health
  • Department: Provider Reimbursement
  • Location: 339 Sixth Avenue, Pittsburgh PA 15222
  • Union Position: No
  • Salary Range: $19.17 to $31.85 / hour

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. The Coordinator 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. The Coordinator must be able to travel to provider sites and to regional offices as needed.




Responsibilities:
  • Attend meetings with providers to instruct in the claim submission process and/or to facilitate the resolution of the provider's claim related issues.
  • 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.
  • Assist with development and presentation of Provider Claims Training.
  • Responsible for understanding and performing job responsibilities consistent with the company's mission statement, values statement, code of conduct and global goals.
  • Manages key projects as assigned; these may changes from time to time. Maintains a list of current projects to disseminate to internal customers.
  • 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.
  • 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.

Qualifications

  • 5 years' experience in a claims processing or provider billing operations required
  • Bachelor's 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/Disability/Veteran

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       Current UPMC employees must apply in HR Direct

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