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Claims Examiner Workers Compensation

  • Job ID: 311137270
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: WKP Comm WC Claims Admin
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: No
  • Salary Range: $17.39 to $27.61 / hour

Description

UPMC Workpartners' Workers Compensation department is seeking a Claims Examiner- Workers Compensation!
This person is responsible for administrative support to the claims management team, responsible for claim set ups, mailing documents, checking error lists and miscellaneous assignments.

Responsibilities:

  • Set up Workers? Compensation claims that are received from the clients within a 24-hour period. Maintain employee confidentiality and privacy.
  • Maintain excellent relationship with clients. Participate in team meetings and provide ideas, suggestions, and feedback to promote effective program management.
  • Perform job duties and responsibilities in accordance to Work Partners Claims Management Standards. Perform other duties as assigned by the supervisor and/or manager.
  • Provide clerical and technical support to the team to achieve operational goals. Maintain the Daily Claim Review and Daily All Claim Validation reports.
  • Maintain the No Claim on File (NCOF) queue. Complete daily Diary requests.

 

Qualifications

  • High School Graduate (college degree, professional certifications and licenses preferred).
  • Minimum 6-12 months clerical, claims or customer service experience.

Experience in workers' compensation, medical management and/or medical terminology preferred.Proficiency in typing requiredProven organizational skillsGood written (grammar and punctuation) and verbal communication skills including the ability to communicate clearly and being a good listener via the telephone.Customer Service oriented Organization skillsDetail oriented

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct