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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

Health Care Concierge, Intermediate

  • Job ID: 142313393
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours: Monday-Friday 8AM - 4PM
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: CM ENROLLMENT
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: No
  • Salary Range: $15.97 to $25.15 / hour

Description

The Health Care Concierge, Intermediate services complex health insurance products across at least two lines of business & acts as an advocate for Health Plan customers (member, provider, facilities, etc.) by providing guidance, interpretation and education on benefit coverage levels, claims payment, and various program inquires. In addition, the Health Care Concierge, Intermediate can serve as a mentor for newly hired staff members and able to manage special assignments to meet member/department needs.

Responsibilities:

  • Handle special projects as assigned.
  • Drive First Call Resolution on every inquiry by completing all necessary outreach calls on behalf of the member.
  • Follow up on and document actions required to service inquiry from UPMC Health Plan members, prospective members and providers.
  • Service two product lines of business and complete cross training as scheduled.
  • Answer and investigate incoming inquiries from UPMC Health Plan members, prospective members and providers.
  • Provide exemplary customer service by being proactive and responsive to all UPMC Health Plan customer requests.
  • Serve as a mentor to newly hired staff members to role model excellent customer service, documentation and follow-up as required by the department
  • Conduct outbound service calls in accordance with departmental initiatives.
  • Service and document inquiries in accordance with UPMC Health Plan quality guidelines.
  • Ability to understand and effectively communicate information regarding a product line or function including benefits and claims information
  • Claims interpretation skills with the ability to learn and understand claims processing.
  • Attend all member service meetings, trainings and power summits as scheduled.
  • Remain current on all departmental policies, procedures, plan benefit designs, and modifications.
  • Manage multiple member inquiries across interaction types including telephonic, fax, online, chat, web messages and email.

Qualifications

  • High school graduate, Associates or college degree preferred.
  • Minimum of 3 years of customer service experience and/or call center experience.
  • Knowledge of Member and Provider Services required.
  • Ability to service 2 lines of business to meet the member services department needs.
  • Demonstrate the ability to go above & beyond to help members.
  • Mentor new hires to be successful.
  • Proficiency in typing required. 
  • Strong writing skills required.
  • Ability to make independent decisions required.  
  • Knowledge of Microsoft Office and Excel spreadsheet program required.
  • Complex analytical skills required to assist customer inquiries.
  • Demonstrates good organizational skills.
  • A desire to help others and portray empathy in all situations.
  • Ability to learn & articulate complex health plan information.
  • Demonstrate flexibility and motivation to learn & grow in the position.
  • Flexibility in work schedule.

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

Total Rewards

More than just competitive pay and benefits, our Total Rewards package cares for you in all areas of life. Designed to help you achieve your goals, Total Rewards support our belief that you’re at your best when you’re receiving the support you need in all areas of life: professional, personal, financial, and more.

Our Values

No matter where we work or what we do, we’re driven by common values that guide our work and keep us accountable to one another. UPMC’s 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

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