COVID-19 Vaccination Information

Across UPMC, our guiding principle is to always prioritize the safety of our employees, patients, and members. UPMC believes that vaccination is important, helps protect all, and advocates that everyone who can be vaccinated should be vaccinated.

UPMC complies with all governmental requirements related to local, state, and federal COVID-19 vaccination for employment. The Jan. 13 Supreme Court of the United States decision that the Centers for Medicare & Medicaid Services federal COVID-19 vaccine mandate will move forward requires UPMC to ensure employees either get vaccinated or receive a requested medical or religious exemption.

If you are not yet vaccinated, we urge you to get a vaccine now. You can schedule your COVID-19 vaccination through UPMC or visit a non-UPMC provider or UPMC Urgent Care location.

Proof of vaccination is not required upon hire; however, employees will be responsible for ensuring post-hire compliance by getting vaccinated or requesting a medical or religious exemption.

For more information about UPMC’s response to COVID-19, please visit UPMC.com/coronavirus.

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Resolution Specialist- Workers Compensation

  • Job ID: 790688557
  • 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: $21.60 to $36.02 / hour

Description

UPMC Health Plan and Workpartners is seeking a Resolution Specialist!
Come be a part of the dynamic and growing workers’ compensation claims department! This position's major responsibility is to investigate, evaluate, document and conclude claims to closure. The position will handle claims with outstanding medical/legal bills, Supersedeas Fund reimbursement, subrogation, etc.

Primarily a remote position with the potential for some in-office. Physical Location of Office: US Steel in Downtown Pittsburgh. 


Responsibilities:

  • Follow internal requirements for closure activity and notification at closure.
  • Make decisions that will expedite bringing claims to closure.
  • Compose closing documents; conduct Bureau reporting at closure.
  • Complete diaries timely and appropriately, and set at appropriate intervals.
  • RiskMaster fields/tabs are completed appropriately.
  • Process claims consistent with clients' and corporate policies, procedures and best practices and also in accordance with any statutory, regulatory and ethics requirements.
  • Engage in conversations with Providers, Attorneys, Insureds and Brokers as needed.
  • Make timely claim payments.
  • When necessary, update claims and reports to the excess carrier(s).
  • Maintain excellent relationships with Insureds, Brokers, Providers and Legal Counsel.
  • Compose clear claim notes that are concise and detailed, and capture activity and plan of action.
  • Approach Supervisors or Manager for guidance on specific claims questions.
  • Document litigation and all other vendor activities.
  • Provide written communications to internal and external parties.
  • Communicate concise action plans, and present plans for moving the case to conclusion with the assistance of the supervisor or manager
  • Evaluate financial reserves for appropriateness.
  • Manage a high volume of work through appropriate time management skills.
  • Complete Reserve Worksheets as needed.

 

Qualifications

  • High School diploma. Bachelor's degree in Business, Communications or related field preferred.
  • One (1) year Workers' Compensation claims management experience.
  • Knowledge of basic workers' compensation management.
  • Strong written and verbal communication skills, including ability to communicate clearly by telephone.
  • Strong clerical, organizational and typing skills.
  • Strong interpersonal and customer service skills.
  • Strong attention to detail.
  • Ability to think critically, solve problems, serve clients, negotiate and embrace new challenges.
  • Ability to work with a team.
  • Strong Microsoft Suite skills: Outlook, Excel, Word, Explorer.
  • Strong time management skills.

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

Total Rewards

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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