Document Process Specialist I

Are you someone who enjoys working behind the scenes to make sure things run smoothly and accurately? As a Document Process Specialist, you'll be at the front line of our claims intake process-ensuring that every paper claim and piece of correspondence entering UPMC Health Plan is handled with precision and care.

This role is a great fit for individuals looking to build a career in healthcare operations. You'll gain hands-on experience with core systems and intake platforms, learn the ins and outs of document management, and develop a strong foundation in health insurance operations-all while contributing to the timely resolution of claims.

You'll be responsible for accurately entering and validating high volumes of health insurance claim data, so attention to detail and strong typing skills are key. Working in a production-based environment, you'll need to make quick decisions and stay focused. If you're someone who thrives in a fast-paced setting and takes pride in getting things right the first time, we'd love to meet you.

What You'll Be Doing

• Enter, validate, and correct health insurance claim and document data using our document intake systems-accuracy is key to keeping operations running smoothly.

• Verify electronically received claims before adjudication, clearing errored records in line with established standards.

• Navigate multiple health plan systems to complete intake processing for a variety of document types with precision and speed.

• Research complex documents to determine the correct department for follow-up, ensuring nothing gets lost in the shuffle.

• Create and manage electronic document tracking, distributing items to the appropriate owners for timely resolution.

• Complete training and confidently enter forms and claims into various system applications or repositories.

• Engage in team meetings, share ideas, and contribute to a collaborative environment focused on client satisfaction and continuous improvement.

• Proactively notify your supervisor or team lead of any issues that could impact client satisfaction or workflow.

• Maintain strict confidentiality when handling employee and insured information.

• Support other departments during high-volume periods or backlogs-teamwork makes the difference.

• High School Diploma or equivalent.

• Must be proficient with data entry using QWERTY keyboard.

• Two years computer experience.

• One year claims experience with knowledge of ICD10, CPT, HCPC codes, billing or claim insurance forms strongly preferred.

• Knowledge of Medical Terminology a plus. Ability to learn multiple System and Repository navigation for research and data validation.

• Must be able to thrive in a fast-paced production environment and contribute to a positive work culture with high levels of repetitive tasks requiring focus and attention to detail.Licensure, Certifications, and Clearances:UPMC is an Equal Opportunity Employer/Disability/Veteran