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We're looking for detail-oriented problem solvers to join our Claims team. This is a full-time hybrid position based in the Pittsburgh area. While you'll primarily work remotely, you'll come into the office occasionally for training, team meetings, and other departmental needs-giving you the best of both worlds.

Why this role matters:

As a Claims Examiner, you'll play a key role in helping our members live healthier, more independent lives. By accurately processing claims, you ensure that people receive the care they need-right in their homes and communities.

What you'll do:

* Review and process moderate to complex claims with precision and efficiency.

* Meet or exceed quality and production standards-your accuracy makes a difference!

* Collaborate with your team, share ideas, and help us continuously improve.

* Support other departments during busy periods and participate in training to grow your skills.

* Maintain confidentiality and uphold compliance standards.

Your schedule:

Daylight hours, Monday-Friday, between 6 a.m. and 5 p.m. No nights, no weekends.

What we're looking for:

* Strong attention to detail and ability to prioritize tasks.

* Comfort working independently in a remote environment while staying connected with your team.

* A commitment to accuracy, teamwork, and client satisfaction.

+ High school graduate or equivalent required.

+ One year of claims processing and/or equivalent education preferred.

+ Knowledge of medical terminology, ICD-9, and CPT coding required.

+ Knowledge of commercial, Medicaid, and Medicare products.

+ Ability to use a QWERTY keyboard. Competent in MS Office and PC skills preferred.

+ Working knowledge of COB (Coordination of Benefits) preferred.

+ Ability to demonstrate organizational, interpersonal, and communication skills.

+ Maintain designated production and quality standards required.Licensure, Certifications, and Clearances:UPMC is an Equal Opportunity Employer/Disability/Veteran