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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   Current UPMC employees must apply in HR Direct

Provider Specialist I

  • Job ID: 278766956
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: ONC00-UPMC Hillman Cancer Center
  • Department: Hillman
  • Location: 5115 Centre Avenue, Pittsburgh PA 15232
  • Union Position: No
  • Salary Range: $18.78 to $31.22 / hour

Description

UPMC Hillman Cancer Center is internationally recognized for its leadership in the prevention, detection, diagnosis, and treatment of cancer and is the region's only comprehensive cancer center designated by the National Cancer Institute.

As the preeminent institution in western Pennsylvania for the delivery of cancer care, the performance of basic, translational, and clinical research, and the education of the next generation of cancer researchers and physicians, UPMC Hillman Cancer Center is exceptionally well positioned to contribute to the global effort to reduce the burden of cancer.

UPMC Hillman Cancer Center is currently hiring a full-time Provider Specialist I to provide billing support to our Shadyside campus. This will be a Monday - Friday, daylight position. 

The Provider Specialist will provide provider information maintenance to the master data repository and the transactional system(s) to aid directory/web productions and claims/1022/check/data processing. Additionally, the Provider Specialist will ensure integrity of provider data for accurate claim adjudication, including PHI. Additional activities include ensuring the accuracy of electronically transmitted data for the purpose of releasing batch claims held for review.

Are you a team player that is looking for a rewarding career in a fast-paced environment?! Apply today!


Responsibilities:

  • Accurately and efficiently updates data into the Mc400 system;
  • Maintains a thorough working knowledge of processes for electronically received data;
  • Notifies the supervisor and/or team leader of any issues that my compromise client satisfaction;
  • Protects the integrity and confidentiality of all provider data and information through physical and electronic measures;
  • Investigates via Filenet software or EDI (Electronic Data Interchange) Inquiry Screen(s) any flagged claims;
  • Creates and maintain new networks in the data systems as needed;
  • Collaborates with provider relations, customer, and/or vendors to evaluate and respond to requests, issues, and questions in a timely and professional manner;
  • Continuously searches for improvement opportunities and notifies the supervisor and/or team leader of trends;
  • Conducts ongoing entry and maintenance to in-network and out-of-network providers into the master data repository and transactional system(s)
  • Verifies electronically received data pre-adjudication;

 

Qualifications

  • High school diploma or equivalent required
  • Bachelor's degree preferred
  • 2 years customer service and/or understanding of Medical claims administrative processes
  • Knowledge of Insurance, Managed Care, or Benefits Administration environment preferred
  • Medical provider billing, credentialing, and working knowledge of medical provider networks a plus
  • Strong oral and written communication skills
  • Professional demeanor with business phone etiquette
  • Competent MS Office (Excel a must)/PC Skills
  • Able to demonstrate strong organizational and interpersonal skills
  • Detail Oriented with strong emphasis on quality
  • Maintain designated production and quality standards required.


Licensure, Certifications, and Clearances:

  • Act 34

  • UPMC is an Equal Opportunity Employer/Disability/Veteran

COVID-19 Vaccination Information

Individuals hired into this role must comply with UPMC’s COVID vaccination requirements upon beginning employment with UPMC. Refer to the COVID-19 Vaccination Information section at the top of this page to learn more.

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