Purpose:

The UPMC Health Plan is hiring a full-time Reimbursement Specialist to support the Hospital Reimbursement department. This role will work Monday through Friday standard daylight hours. The team is currently utilizing a hybrid work model and is required to be onsite in downtown Pittsburgh's US Steel Tower 3 days per week.

The Reimbursement Specialist is an analytical position responsible for managing all aspects of provider reimbursement. This includes establishing and maintaining compensation rates for hospitals, physicians, and ancillary services.

Responsibilities:

+ Out of network negotiations when required.
+ Attend meetings when required
+ Complete special projects accurately and timely.
+ Resolve reimbursement issues.
+ Update and maintain hospital reimbursement reports for all product lines. Report include inpatient base rate comparisons, outpatient reimbursement comparisons to UPMC OP fee schedule, Observation cost per cas...