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   Current UPMC employees must apply in HR Direct

Verification Processor

  • Job ID: 018613797
  • 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
  • Union Position: No
  • Salary Range: $15.42 to $24.17 / hour

Description

UPMC Health Plan is seeking a full-time Verification Processor to support the Department of Mailroom Operations!
In this position, you will provide for ensuring the 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

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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