UPMC Health Plan

Compensation

Full Description

Do you enjoy solving problems and helping others succeed? As a Provider Service Representative, you'll be the go-to resource for providers, vendors, and facilities-making sure they have the answers and support they need. You'll guide them through eligibility, benefits, claims, and more, ensuring every interaction is clear, accurate, and professional. This isn't just a job-it's an opportunity to make a real impact by building trust and confidence in our Health Plan. You'll play a key role in strengthening provider relationships while delivering exceptional service. Why You'll Love This Role • Competitive pay: $21.70/hour • Comprehensive benefits: Health, dental, vision, and more • Career growth: A clear path for advancement • Training that sets you up for success: We provide full on-the-job training • Flexibility: Work from home or choose an in-office option • Standard hours: Monday-Friday, 8:00 a.m.-5:00 p.m. (Candidates must live within 90 miles of Pittsburgh or Erie.) What You'll Do • Be the primary point of contact for providers and vendors-answering questions about claims, benefits, authorizations, billing, and network participation. • Respond to inbound calls, emails, and chats with professionalism and accuracy. • Explain processes and policies clearly so providers know exactly what to do next. • Research claims and benefits to provide timely, informed solutions. • Document every interaction accurately in our systems. • Navigate multiple tools while staying focused and responsive. • Make outbound calls to provide updates or resolve issues. • Stay current on policies and system updates through ongoing training. • Collaborate with your team and participate in skill-building sessions. What It Takes This role is fast-paced and requires strong multitasking skills, quick thinking, and the ability to stay calm under pressure. If you're organized, tech-savvy, and passionate about helping others, you'll thrive here. Work-From-Home Requirements • Internet speed: 20 Mbps download / 5 Mbps upload • Ping: <50ms, Jitter: <10ms • Direct connection via Ethernet cable (WiFi and hotspots not allowed) • Compatible service: Cable or fiber (Satellite, DSL, and mobile hotspots are not allowed) A speed test will be required upon offer acceptance. Ready to make a difference and grow your career? Apply today and join a team that values your skills and commitment to service excellence! • High school graduate or equivalent. • 2 years customer service experience or call center experience required OR1 year health insurance call center and claims adjustments experience required. • Proficient in typing and writing skills required. • Ability to make independent decisions required. • Knowledge of Microsoft Office and Excel spreadsheet program preferred. • Complex analytical skills necessary to evaluate customer inquiries. • Demonstrates good organizational skills. • A desire to help others and portray empathy in all situations. • Ability to learn complex health plan information. • Demonstrate flexibility and motivation to learn & grow in the position. • Flexibility in work schedule Licensure, Certifications, and Clearances: UPMC is an Equal Opportunity Employer/Disability/Veteran