Top 461 Regulatory specialist Jobs in Pittsburgh Pa

Enrollment Specialist I
UPMC —Pittsburgh, PA
- $19.47 - $30.40 an hour
- Full-time
- Microsoft Office
- Leadership
- Communication skills
Supply Specialist
UPMC —Pittsburgh, PA
- $19.60 - $30.25 an hour
- Full-time
- Hospital
- High school diploma or GED
- 1 year
- Tuition reimbursement
5d
Inventory Specialist
Aurora Innovation —Pittsburgh, PA
- $30 - $42 an hour
- Hybrid work
- Forklift
- Driver's License
- Warehouse
Quick Apply
Senior Specialist, Regulatory Oversight Management
The Bank of New York Mellon Corporation —Pittsburgh, PA
- Full-time
- Research
- Office
- Bachelor's degree
Regulatory Specialist - (GI Ctr.) - Oncology
UPMC —Pittsburgh, PA
- $27.89 - $48.21 an hour
- Full-time
- Mid-level
- Bachelor's degree
- Computer skills
5d
Enterprise Testing Specialist Senior
PNC Financial Services Group —Pittsburgh, PA
- $63,750 - $106,250 a year
- Full-time
- Data analysis skills
- Office
- 3 years
- Wellness program
- Health savings account
Regulatory Implementation and Assurance Analyst - Audit Oversight
Highmark Inc. —Pittsburgh, PA
- Full-time
- Hybrid work
- 6 years
- CPA
- Writing skills
Intermediate Cust Relations Specialist
PNG Companies LLC —Pittsburgh, PA
- Full-time
- Mid-level
- Office
- Bachelor's degree
- Opportunities for advancement
Quick Apply
Air Quality and Regulatory Compliance Specialist
PennEnergy Resources LLC. —Cranberry Township, PA
- Extended hours
- Microsoft Outlook
- Mid-level
- Office
Learning & Talent Development Specialist - Retail Branch Facilitation
PNC Financial Services Group —Pittsburgh, PA
- $37,000 - $97,500 a year
- Full-time
- Classroom
- Mid-level
- Bachelor's degree
- Wellness program
- Health savings account
10d
Specialist, Risk and Compliance Services (Center of Excellence)
Deloitte —Pittsburgh, PA
- $63,000 - $116,000 a year
- Full-time
- Microsoft Outlook
- Research
- Mid-level
14d
Environmental Protection Specialist
Commonwealth of PA —Pittsburgh, PA
- $60,538 - $92,010 a year
- Full-time
- Mid-level
- Office
- Master's degree
- Paid parental leave
- Health insurance
3d
Specialist, EHS
EOS Energy Storage —Turtle Creek, PA
- Full-time
- Mid-level
- Associate's degree
Adjudication Specialist
PNC Financial Services Group —Pittsburgh, PA
- Full-time
- Background check
- Customer service
- Research
- Wellness program
- Health savings account
1d
Integrations Specialist - Implementation
Hardenbergh Group —Pittsburgh, PA
- $55,000 - $68,000 a year
- Full-time
- Remote
- Mid-level
- Health savings account
- Disability insurance
Quick Apply
1d
Warehouse and Delivery Specialist
UPMC —Pittsburgh, PA
- $19.80 - $30.40 an hour
- Weekends as needed
- OSHA
- Customer service
- DOT physical examination
- Tuition reimbursement
Access Authorization Specialist
Westinghouse Electric - USA —Madison, PA
- $20 - $22 an hour
- Hybrid work
- Office
- Residential
- High school diploma or GED
- Health insurance
Quick Apply
11d
Quality Specialist
Westinghouse Electric Company —Cranberry Township, PA
- $64,800 - $81,000 a year
- Hybrid work
- Mid-level
- Office
- 3 years
- Health savings account
- Paid holidays
Training Specialist
ACHIEVA SUPPORT —Pittsburgh, PA
- $22.05 - $23.59 an hour
- Full-time
- Background check
- Computer literacy
- Mid-level
- AD&D insurance
- Paid holidays
Quick Apply
Senior Supply Specialist
UPMC —Pittsburgh, PA
- $19.80 - $30.40 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Operating room
- Tuition reimbursement
11d

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Enrollment Specialist I

UPMC -
Pittsburgh, PA

Apply Now

Job Details

Full-time
$19.47 - $30.40 an hour

Qualifications

Microsoft Office

Full Job Description

UPMC Health Plan has an exciting opportunity for an Enrollment Specialist I position in the Medicare SNP Enrollment department. This is a full-time hybrid position based in the Pittsburgh/Erie area. While you'll primarily work remotely, you'll come into the office occasionally depending on departmental needs.

This position has a set rate of $20.70/hr.

The Enrollment Specialist will be responsible for the creation and maintenance of eligibility in the transactional system, responding to both internal and external customer inquiries, and resolving issues to meet or exceed service requirements. To successfully perform the role, an Enrollment Specialist must have a comprehensive understanding of enrollment regulations and complete all duties with strict regard to policies and procedures. Completes all duties with strict regard to policies and procedures set forth by Enrollment Services Manager, Centers for Medicare and Medicaid Services (CMS), Pennsylvania Department of Welfare (DPW), and Pennsylvania Insurance Department (PID). Performs duties related to the processing and maintenance of all member requested transactions, include generation of required letters to ensure enrollment and/or disenrollment processes are completed compliantly. The role also involves direct interaction with internal and external customers to resolve inquiries and concerns including but not limited to outbound phone calls to members.

Responsibilities:

Understanding of varied and detailed enrollment and disenrollment requirements and processing rules based upon the product (HMO, PPO, EPO, SNP, PDP, Select, Supplemental, or National Complimentary) and Individual vs. Employer Group, including, but not limited to, understanding and application of service areas by product.
Maintain employee/insured confidentiality.
Ability to analyze information to make appropriate decisions regarding enrollment/disenrollment, complying with applicable regulations and governance.
Interact with Sales staff to ensure all required date elements for completed application are received and any issues are addressed timely, in accordance with compliance requirements.
Ability to make eligibility determinations based on CMS (Part A/Part B Eligibility), DPW (Medical Assistance Eligibility), and/or PID requirements, in accordance with the application election period guidelines. Ability to accurately identify appropriate election period based upon analysis of beneficiary/member history and regulatory guidance.
Comprehension and application of eligibility regulations to process enrollment transactions and generation of corresponding letters to members. Must keep up to date with new regulations and guidance.
Process all types of enrollment and disenrollment transactions in accordance with company policies and procedures in a timely manner while meeting production and quality goals.
Initiation and generate of appropriate correspondence based on type of transaction processed, includes initiation of outreach requests and written correspondence (letters), as necessary.
Daily clerical responsibilities related to processing and electronic storage of member correspondence.
Identify areas of concern or trends that may compromise client satisfaction or compliance with government regulations.
Support team projects within Enrollment Services; other projects as assigned.

High school graduate or equivalent required, college degree preferred.
Minimum of six months of customer service and/or call center experience.
Ability to interpret and apply complex eligibility regulations as mandated by CMS, DPW, and PID.
Demonstrates good organizational, interpersonal, leadership and communication skills.
Attention to detail is critical to the success of this position, with skills in customer orientation.
Will need to manage multiple tasks and projects.
MS Office/PC skills required.

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

Apply Now

Refine Your Search

regulatory specialist jobs in pittsburgh pa

Enrollment Specialist I

Supply Specialist

Inventory Specialist

Senior Specialist, Regulatory Oversight Management

Regulatory Specialist - (GI Ctr.) - Oncology

Enterprise Testing Specialist Senior

Regulatory Implementation and Assurance Analyst - Audit Oversight

Intermediate Cust Relations Specialist

Air Quality and Regulatory Compliance Specialist

Learning & Talent Development Specialist - Retail Branch Facilitation

Specialist, Risk and Compliance Services (Center of Excellence)

Environmental Protection Specialist

Specialist, EHS

Adjudication Specialist

Integrations Specialist - Implementation

Warehouse and Delivery Specialist

Access Authorization Specialist

Quality Specialist

Training Specialist

Senior Supply Specialist

I want to receive the latest job alert for regulatory specialist in pittsburgh pa

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