Position Summary The Claims Quality Review Technician is responsible for performing detailed quality reviews of processed claims to ensure accuracy and compliance with eligibility rules, benefits paid, client requirements and applicable legislative and regulatory guidelines. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Reviews processed claims, including hospital, medical, dental, vision, prescription and time loss to confirm accuracy and appropriate adjudication of benefits. Identify and document quality trends, provide feedback, and assist management in monitoring processing performance against established standards. Reviews and interprets new benefit plans and/or benefit plan changes, develops resource materials and acts as a resource for staff. Conducts training for new and current employees on claims adjudication, contract...

Position Summary The Supervisor, Trust Accounting provides daily leadership and oversight to a Trust Accounting team in accordance with Company guidelines, client needs, and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Provides daily leadership and supervision to staff consistent with management values and mission. Assigns, distributes, and monitors quality and quantity of work produced, ensuring employees are held accountable for consistently meeting quality and production requirements. Develops staff through performance management, goal setting, training, and effective employee relations. Optimizes workflows/processes, tools, and staff allocation to ensure efficient and cost-effective day to day operations. Employs management oversight measures to ensure ongoing compliance with regulatory and legal...

Title: Receptionist                                 Department: Technical Operations Union: Teamsters 853                          Grade: 1 Position Summary The Receptionist ensures every visitor or phone call is directed to the appropriate staff member in the assigned office.   "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Answers and efficiently routes incoming calls accordingly. Documents and distributes messages as necessary. Greets visitors to the reception area and contacts appropriate staff to assist. Maintains lobby and reception area in an organized and professional manner. Performs clerical duties such as filing and preparing documents for mailing as needed. Performs other duties as assigned. Minimum Qualifications High school diploma or GED. Six months of experience working in a...

Position Summary The Supervisor, Trust Accounting provides daily leadership and oversight to a Trust Accounting team in accordance with Company guidelines, client needs, and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Provides daily leadership and supervision to staff consistent with management values and mission. Assigns, distributes, and monitors quality and quantity of work produced, ensuring employees are held accountable for consistently meeting quality and production requirements. Develops staff through performance management, goal setting, training, and effective employee relations. Optimizes workflows/processes, tools, and staff allocation to ensure efficient and cost-effective day to day operations. Employs management oversight measures to ensure ongoing compliance with regulatory and legal...

Title: Sr. Records Clerk                                Department: Claims Union: OPEIU 29                  Grade: 15 Position Summary The Sr. Records Clerk maintains clerical queues and mailboxes related to eligibility and correspondence and ensures workflows are handled within assigned guidelines. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains member and dependent files in appropriate system; reviews and enters information relative to the support of the operations staff  Generates and releases forms and letters as required. Performs clerical duties which may include preparing enrollment packets, processing mail, copying, faxing, scanning, or filing. Provides general office support as assigned by leadership Performs other duties as assigned. Minimum Qualifications High school diploma or GED. One year...

Title: Customer Care Advocate Department: Customer Care Union: Teamsters 986 Grade: 20 FLSA: Non-exempt Hours per week: 40 Position Summary The Customer Care Advocate provides customer service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies knowledge in all job functions. Provides written, verbal, or face-to-face customer service by responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits. Updates files, including documenting system notes of conversations or action taken. Performs tasks associated with the administration of retirement and health and welfare benefits such as; Processing...

Position Summary Litigation Support Specialist provides advanced data support to projects related to confidential client information in claims litigation in accordance with company policy, regulatory requirements, and client needs. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains historical and current knowledge of processes, determinations, and outcomes for assigned client. Maintains working knowledge of prior and current systems of assigned client. Understands and able to work in and pull data from multiple platforms. Conducts audits and research to provide historical information on processes, determinations, and outcomes for assigned client. Provides progress updates at case team meetings to report on the progress of assigned tasks. Acts as technical resource to Litigation Support team on historical systems...

Title: Customer Care Advocate Department: Customer Care Union: Teamsters 986 Grade: 20 FLSA: Non-exempt Hours per week: 40 Position Summary The Customer Care Advocate provides customer service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies knowledge in all job functions. Provides written, verbal, or face-to-face customer service by responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits. Updates files, including documenting system notes of conversations or action taken. Performs tasks associated with the administration of retirement and health and welfare benefits such as; Processing...

Position Summary Manages accounts receivable fund operations and supports client services, in accordance with Company guidelines, client needs and legislative requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Provides daily leadership and supervision to staff consistent with management values and mission. Assigns, distributes, and monitors quality and quantity of work produced, ensuring employees are held accountable for consistently meeting quality and production requirements. Develops staff through performance management, goal setting, training, and effective employee relations. Maintains current knowledge of assigned Plan(s) and effectively applies knowledge. Optimizes workflows/processes, tools, and staff allocation to ensure efficient and cost-effective day to day operations. Troubleshoots customer/client service...

Title: Medical Claims Examiner           Department: Claims Union: OPEIU 12             Grade: 26 Position Summary The Medical Claims Examiner provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims. Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers’ Compensation, or disability.  May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries. Performs other duties as assigned. Minimum Qualifications High...

Position Summary The Staff Accountant provides financial accounting in accordance with Company guidelines, client needs, and legislative requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Completes month end and year end closing processes, including preparation and input of journal entries, balance sheet reconciliations, bank reconciliations, and revenue summaries. Distributes monthly financial statements, researches and resolves income statement discrepancies, and responds to branch inquiries and requests. Audits financial statements for review by outside auditors. Assists in the development, implementation and monitoring of internal accounting systems and policies and procedures to ensure operations remain in compliance with regulations and reporting requirements. Performs accrual accounting functions including preparing...

Position Summary The Client Relationship Manager supports the Director, Client Relationship across their book of business (BOB) in fund management, with direct client and vendor liaison as required by the Director, Client Relationship. The Client Relationship Manager works alongside the Director, Client Relationship to learn the role, with a gradual increase in responsibility as appropriate. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Monitors government filings and current government regulations that may affect the operations of the Company or the client.  Facilitates client meetings, including minute-taking and recording key actions from board meetings. Manages contracts and documentation including client financial statements, Summary Plan Descriptions, benefit communications, and other documents at the direction of client...

Position Summary The Client Relationship Director directly leads a defined book of business (BOB), comprising a set of named clients, in accordance with Company guidelines, client needs, and regulatory requirements. The Director, Client Relationship acts in a mentorship role to their BOB’s assigned team. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Manages all aspects of the client relationship and account management activities of the assigned client(s) to retain and strengthen client relationships. Directs the execution of a defined account strategy, remaining abreast of the specific needs of each assigned client, to develop a value-based client relationship. Sets and manages client expectations and account-related activities such as identifying and developing additional service opportunities and coordinating the delivery of ZAS...

Title: Retirement Benefits Reviewer                                 Department: Pension Union: UFCW 1546                                                               Grade: 25 Position Summary The Retirement Benefits Reviewer performs administrative duties associated with the review and validation of retirement benefits in accordance with Company policies, regulatory requirements, and Plan guidelines.          "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s). Performs quality review of processed retirement benefits applications. Validates accuracy and completeness of data used to calculate benefits. Reviews and verifies accuracy of benefit calculations. Reviews correspondence to be sent to participant for accuracy and completeness. Performs final quality review of participant...

Position Summary The Software Developer, Sr performs complex coding, designs program logic and modifications, performs feasibility studies, and analyzes and designs system applications, in accordance with Company guidelines and client requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Analyzes user requirements and/or complex problems with new and existing software applications. Writes program code, tests and debugs code, and documents changes. Develops application specifications to satisfy user needs and to improve user productivity. Develops test data and performs testing to validate programming results. Creates operation procedures and system documentation, provides problem resolution and production support, and trains and assists users on applications. Resolves customer/client service programming problems and assists in the...

Title: Bookkeeper Department: Trust Accounting Position Type: Non-Exempt Hours per Week: 40 Internal Posting Deadline: Position Summary The Bookkeeper provides financial accounting for assigned Client(s) and Trust Fund(s) in accordance with company policies, regulatory requirements, and plan guidelines. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Balances FICA, federal withholding, and payroll taxes; makes appropriate deposits. Reconciles checking, savings, and investments accounts. Posts journal entries to general ledger. Prepares and distributes Trust financial statements and statistics. Assists in the preparation of 941 and 945 forms. Ensures accounting files are current and in good order. Reviews vendor invoices for accuracy and reasonableness. Makes daily/weekly money transfers as needed. Prepares and...

Title: Retirement Benefits Processor                                 Department: Pension Union: Teamster 853                                                             Grade: 4 Position Summary The Retirement Benefits Processor performs technical and administrative duties associated with the processing and verification of participants' retirement benefit inquiries and applications in accordance with Company policies, regulatory requirements, and plan guidelines. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s). Processes retirement benefit applications; verifies the accuracy of information, researches or investigates past service, related credits, and insurance deductions. Responds to inquiries from participants, beneficiaries, and union representatives, directly or indirectly,...

Title: Bilingual Pension Specialist Department: Associated Administrators Position Type: Non-Exempt Hours per Week: 40   Position Summary The Pension Specialist performs technical and administrative duties associated with the processing and verification of participants' retirement benefit inquiries and applications in accordance with Company policies, regulatory requirements, and plan guidelines. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Processes retirement benefit applications; verifies the accuracy of information, researches or investigates past service, related credits, and insurance deductions. Responds to inquiries from participants, beneficiaries, and union representatives regarding retirement benefits. Determines benefit eligibility and requests necessary documentation from unions, employers, and the Social Security...

Title: Accounts Receivable Processor II                       Department: Contribution Accounting Union: Teamsters 986                                                     Grade: 20 Position Summary The Accounts Receivable Processor 2 provides account reconciliation and resolves customer inquiries for assigned Trusts ensuring compliance with associated plans and company guidelines.   "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Handles customer inquiries via telephone, electronic modes, and in-person for billing questions to stakeholders such as employers, providers, auditors, or client representatives. Processes COBRA payments, self-pay payments, refund requests, and cash receipts. Receives and processes new employer contracts. Maintains and updates existing contracts. Prepares and processes incoming and...

Position Summary The Technical Business Analyst will conduct data analysis, address problem-solving challenges, and develop processes utilizing the Basys software to meet the needs of our clients effectively. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Implement the daily processes for producing data and reports within the computer systems. Provide prompt responses and practical solutions to challenges. Address software and program issues by thoroughly analyzing system problems to identify software errors and formulate appropriate corrective actions. Develop and produce forms, reports, and other necessary documents for both users and management as required. Facilitate the necessary electronic transfer of data as required. Performs other duties as assigned. Minimum Qualifications Associate’s degree in information...