Verification Processor

in Pittsburgh, PA

Verification Processor Job

Job Description Job Attributes+

  • Job ID

    97236498

  • Req #

    4827125

  • Organization

    UPMC Health Plan

  • Department

    Claim Intake Ver-Mail SV

  • Job Category

    Billing & Registration

  • Job Location

    600 Grant St, Pittsburgh, PA 15219, US

  • Job Type

    Full-Time - Regular

  • Shift

    Day Job

  • Salary

    14.26 - 22.35 / HOUR

  • Remote

    No

Description


Provide for ensuring accuracy of electronically transmitted data for the purpose of releasing batch claims held for review.

Responsibilities:
  • Update data into the Amisys system accurately and efficiently.
  • Verify and correct as necessary claims received through the FormWorks process to include but not be limited to - Individual characters and fields in OCRepair and OCRepCrit, Information contained in KE (Key Entry).
  • Complete UB's and HCFA's in FormWorks for claims unable to process directly via OCR (KFI/Key From Image).
  • Notify the supervisor and/or team leader of any issues that my compromise client satisfaction.
  • Verify electronically received data pre-adjudication.
  • Investigate via Filenet software or EDI (Electronic Data Interchange) Inquiry Screen(s) any flagged claims.
  • Claim hold/Batch error correction
  • Search continuously for improvement opportunities and notifies the supervisor and/or team leader of trends.
  • Maintain a thorough working knowledge of processes for electronically received data;

Qualifications

  • Completion of High school diploma or equivalent.
  • Able to use a QWERTY keyboard;
  • Knowledge of Insurance, Managed Care, or Benefits Administration environment preferred;
  • Prefer competency in MS Office and PC skills.
  • Able to demonstrate organizational, interpersonal, and communication skills.
  • Maintain designated production and quality standards required.
  • Previous mailroom experience is preferred.

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

Additional Information

Who We Are

<p>At UPMC, we're all here for the same reason - to provide outstanding care. From nursing to finance, pharmacy to software development, each of us contributes in our own way, in our own career path. </p><p>We encourage growth through leadership development, skill building, and continuing education, so that employees can explore their interests and define their careers, while always playing a part in life changing medicine. And, while our opportunities vary, we remain united by the same values across our system:
</p><ul><li>Quality &amp; Safety</li><li>Dignity &amp; Respect</li><li>Caring &amp; Listening</li><li>Responsibility &amp; Integrity</li><li>Excellence &amp; Innovation
</li></ul><p>If you too are driven by these values, we’re ready for you. Find your ideal job at UPMC today!</p>

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