Claims Examiner- Part Time

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