Claims Services Representative

Job description

Location: Marquette,Michigan,United States DATE: April 24, 2026: POSITION Claims Services Representative: DEPARTMENT: Operations - Provider Relations: BASE RATE: $18.50 per hour, with potential for additional compensation based on qualifications POSITION SUMMARY: This position is responsible for resolving and responding to provider inquiries relating to claims and claims payment in accordance with organizational policies, regulatory requirements, and contractual obligations. This position supports all lines of business to include Medicaid, Medicare, and commercial. This position will communicate with providers about claims payment in an efficient and compassionate manner and in accordance with Upper Peninsula Health Plan (UPHP) policies and procedures. This role plays a critical part in ensuring providers are reimbursed correctly while supporting claims integrity and provider satisfaction. ESSENTIAL DUTIES AND RESPONSIBILITIES: 1. Follows established Upper Peninsula Health Plan (UPHP) policies and procedures, objectives, safety standards, and sensitivity to confidential information. 2. Addresses all provider claims and payment-related inquiries including, but not limited to, benefi...