Job Type

Full-time
Description
As one of the Top 20 Health and Human Service Nonprofits in Pittsburgh we are making a difference in the lives of many frail elders in Allegheny County. LIFE Pittsburgh offers a comprehensive benefit package including Medical, Dental, Disability, 401K , free parking, paid time off and holidays, including your birthday! This position will be hybrid work from home once training is complete.
Under the direction of the Director of Health Plan Administration, the Health Plan Specialist will be responsible for maintaining health care claims authorizations from all internal authorization tracking systems into the claims processing system. Will also be responsible for researching and resolving claims with missing authorizations to assist with the adjudication process. The position will also provide support for health plan administration tasks such as: maintaining eligibility data within the claims processing system, census reports and CMS reporting.
Requirements
High School Diploma or GED required (bachelors preferred) plus a minimum of 1-3 years of relevant experience with Health Care Administration or Claims Processing. Must have experience working within one of the following: health care, managed care environment, Medicare/Medicaid insurance program. Must also have excellent communication skills with all levels of staff and have the ability to work with external contacts along with proficiency in Microsoft Office, Excel, flat files, and other software applications. Also, provide quick and accurate data entry skills.