Document Process Specialist I - Hybrid

Document Process Specialist I

UPMC Health Plan has an exciting opportunity for a Document Process Specialist I position in the Claim Intake Ver-Mail SV department. This is a full-time hybrid position based in the Pittsburgh area.

Launch your career with a role that serves as a critical part of our operations. This position offers a unique opportunity to gain exposure to key business processes while ensuring the accuracy and integrity of claims and correspondence workflows. Responsibilities include validating electronically transmitted data, conducting detailed research across multiple systems, performing essential data entry functions, and creating electronic tracking records that support the timely and accurate distribution of important documentation and correspondence. This is an excellent opportunity to develop valuable operational skills while building a strong foundation for growth within the organization.

Responsibilities:

• Enter, validate, and correct claim and document information through document intake systems.
• Verify claims electronically received pre-adjudication, clearing errored records in accordance with designated standards.
• Access multiple health plan systems to accurately complete intake processing for various document types.
• Accurate and timely research of complex documents to determine responsible department.
• Create an electronic document tracking distributing to the appropriate owner.
• Successfully complete training and enter forms/claims into the various system applications or repositories.
• Openly participate in team meetings, provide ideas and suggestions to ensure client satisfaction, and promote teamwork.
• Notify the supervisor and/or team leader of any issues that may compromise client satisfaction.
• Maintain employee/insured confidentiality.
• Assist other departments during periods of backlogs.

Qualifications:

• High School Diploma or equivalent.
• Must be proficient with data entry using QWERTY keyboard.
• Two years computer experience.
• One year claims experience with knowledge of ICD10, CPT, HCPC codes, billing or claim insurance forms strongly preferred.
• Knowledge of Medical Terminology a plus.
• Ability to learn multiple System and Repository navigation for research and data validation.
• Must be able to thrive in a fast-paced production environment and contribute to a positive work culture with high levels of repetitive tasks requiring focus and attention to detail.
• Licensure, Certifications, and Clearances: Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran