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   Current UPMC employees must apply in HR Direct

Provider Reimbursement Project Coordinator

  • Job ID: 242916433
  • 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: $19.41 to $32.25 / hour

Description

Are you detail-oriented? Do you have a background in medical billing or medical claims? Whether you're looking for a collaborative team setting, a career path that can lead to leadership, an excellent work-life balance, or experience with an industry leader, our Provider Reimbursement Adjustment Coordinator opportunity offers many ways for you to get involved!

The Provider Reimbursement Project Coordinator is a Monday - Friday, daylight role (8:00 a.m. - 4:30 p.m.) based in downtown Pittsburgh, PA. Due to COVID-19 circumstances, this will be a hybrid role, with some remote/work-from-home privileges and some travel into the office. Occasional travel to other Community Care offices may be required.

Call center experience and proficiency in Microsoft Excel proficiency is preferred.

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. They 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. 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
  • Act 34

    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