UPMC
Description
This position will lead a Claim Operations production team that focuses on front end processes with downstream impacts. This person will focus on employee and leadership growth/development and work experience, to further cultivate a culture of engagement, while overseeing day-to-day operations. They will also collaborate with senior leaders to optimize department processes and systems while building relationships with stakeholders and customers.
- Provide leadership and direction through developing and updating procedures, programs, determining appropriate production standards, determining staffing requirements, and training opportunities.
- Maintenance of communication with new and established customers.
- Serve as liaison to customers by facilitating demonstrations of operations activities.
- Effectively interact with internal and external customers.
- Recruit and discharge employees when necessary.
- Maintain designated standards established for handling incoming work.
- Manage and direct all activities and special projects.
- Provide central coordination and control for implementation of new/changed application and systems.
- Create programs that promote employee engagement and develop a positive work experience.
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Develop or manage programs to enhance employee development.
Qualifications
- Bachelor’s Degree preferred.
- 5 years of business experience required.
- Prior management experience with automated claims processing is mandatory.
- Knowledge of medical terminology, ICD-9, and CPT coding required.
- Knowledge of commercial, Medicaid, and Medicare products.
- Competent in MS Office and PC skills. Able to demonstrate organizational, interpersonal, and communication skills.
- Maintain designated production and quality standards.
- Ability to react to users needs in a timely and efficient manner.
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Direct staff with minimal amount of supervision.
Licensure, Certifications, And Clearances
- Act 34
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UPMC is an Equal Opportunity Employer/Disability/Veteran
Total Rewards
More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life — because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.
Our Values
At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.
