CLAIMS EXAMINER WORKERS COMP

Job ID: 7001538592
Status: Full-Time
Regular/Temporary: Regular
Shift: Day Job
Facility: UPMC Health Plan
Department: TPA WC Claims
Location: 600 Grant St, Pittsburgh, PA
Union Position: No
Salary Range: $ 19.58-31.08 USD
UPMC Health Plan is hiring a full-time Claims Examiner Workers Comp. The team is based out of downtown Pittsburgh; however this position will be predominantly working from home and will work standard daylight hours, Monday through Friday. Travel into the office will occasionally be required as needed.
This position is responsible for administrative support to the claims management team. They will be responsible for claim set ups, mailing documents, checking error lists and miscellaneous assignments.

QUALIFICATIONS:

• High School Graduate (college degree, professional certifications and licenses is a bonus).
• Minimum 6-12 months clerical, claims or customer service experience.
• Experience in workers’ compensation, medical management and/or medical terminology is a bonus.
• Proficiency in typing required
• Proven organizational skills
• Good 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 skills
• Detail orientedLICENSURE, CERTIFICATIONS, AND CLEARANCES:
• Act 34

• 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.