Claims Examiner (Workers Compensation, Hybrid)

UPMC's Health Plan and Workpartners are hiring a Claims Examiner for their Workers Compensation Claims Admin team.This is a hybrid position and will require travel into the US Steel Tower office several times a week.Responsible for administrative support to the claims management team. Responsible for claim set ups, mailing documents, checking error lists and miscellaneous assignments.Responsibilities:

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.

High School Graduate (college degree, professional certifications and licenses preferred).

Minimum 6-12 months clerical, claims or customer service experience.

Experience in workers' compensation, medical management and/or medical terminology preferred.

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 oriented Licensure, Certifications, and Clearances:

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UPMC is an Equal Opportunity Employer/Disability/Veteran