Verification Processor Job
Job Description Job Attributes+
UPMC Health Plan
Claim Intake Ver-Mail SV
Billing & Registration
600 Grant St, Pittsburgh, PA 15219, US
Full-Time - Regular
14.26 - 22.35 / HOUR
Provide for ensuring accuracy of electronically transmitted data for the purpose of releasing batch claims held for review.
- 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;
- 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
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 & Safety</li><li>Dignity & Respect</li><li>Caring & Listening</li><li>Responsibility & Integrity</li><li>Excellence & 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>