Position Summary The Claims Technical Review Specialist provides advanced technical review of all types of claims 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 Performs technical review and analysis of all types of claims, including large dollar and technically complex claims, to ensure accuracy and adherence to prescribed procedures and plan guidelines. Coordinates appeals through research and documentation; generates denial or approval letters. Coordinates predetermination reviews and performs analysis to determine benefit allowance and benefit category on all types of claims. Perform all functions of Third-Party Recovery (TPR); communicates with members, dependents, insurance companies, providers, and attorney offices throughout the process....

Title: A/R Processor 2                               Department: Contribution Accounting Union: OPEIU 537                                        Grade: 5 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 outgoing contribution reports; reconciles reports to...

Title: Pension Processor                         Department: Pension Union: OPEIU 12                                        Grade: 26 Position Summary The Pension 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). Scans applications and all relevant documents into appropriate system. Processes retirement benefit applications; verifies the accuracy and completeness of information, researches or investigates past service, related credits, and insurance deductions. Responds to inquiries from participants, beneficiaries, and union representatives,...

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 and fund counsel....

Position Summary The Accounts Receivable Employer Advocate serves as the subject matter expert and advisor for all Accounts Receivable processes, driving efficiency, accuracy, and compliance across internal operations and external client partnerships. This role leads process improvement initiatives, supports complex reconciliation and remittance issues, and ensures adherence to government, client, 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 Serves as the department expert on end-to-end Accounts Receivable workflows from employer submission through internal processing, reconciliation, and financial reporting. Works collaboratively with internal teams and external client employers to establish, communicate, and implement best practices for Accounts Receivable Leads the evaluation, design, and...

Title:   Customer Care Advocate, Sr   Department:   Customer Care Union:   UFCW 3000 Bothell   Grade:  9 FLSA:   Non-exempt   Hours per week:   40 Position Summary The Customer Care Advocate, Sr provides advanced 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...

Title: Customer Care Advocate Department: Customer Care Union: Local 154 Grade: 2 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 and/or...

Key Duties and Responsibilities Provide daily oversight to assigned staff consistent with Zenith values and mission. Assign, distribute and monitor quality and quantity of work produced, insuring employees are held accountable for consistently meeting quality and production requirements. Train staff on departmental tasks, procedures and processes as needed. Monitor and manage team performance, up to and including timekeeping, service, and adherence to company policies and procedures Manage incoming mail, ensuring mail is properly scanned, logged and delivered to the right department; and checks are secured until delivery Oversee outgoing mail, ensuring proper postage is charged to correct client and all mail is dispatched regularly. Manage reception desk and provide coverage as needed; ensure calls and visitors are addressed timely, professionally and tracked properly Identify areas of organizational improvement which may include creating new procedures and/or...

Title: Customer Care Advocate Department: Customer Care Union: Local 154 Grade: 2 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...

Title:  Customer Care Advocate  Department:  Customer Care Union:  Teamsters 853  Grade:  3 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 and/or...

Title: Claims Clerk                                      Department: Claims Union: Teamsters 853                               Grade: 2 Position Summary The claims clerk is responsible for providing clerical support to the claim’s unit.   "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role."     Key Duties and Responsibilities Perform alphabetical and numeric filing of claims in accordance with established procedures. Open, date stamps, sort, count, and deliver incoming mail. Process outgoing mail, including overnight and special delivery letters and packages. Attach correspondence to completed scanned files. Key claims information into the system (indexing). Assist with envelope stuffing and mailings. Provide back-up responsibilities for receptionist position. Performs other duties as assigned.   Minimum Qualifications High school diploma or general education degree...

Title: Eligibility & Enrollment Processor 2                          Department: Technical Operations Union: UFCW 1546                                                                  Grade: 22 Position Summary The Eligibility and Enrollment Processor 2 supports the administration of member eligibility and enrollment activities by maintaining accurate records and responding to member and client inquiries. This role applies knowledge of assigned benefit plans to research and resolve eligibility issues and ensure accurate processing of enrollment information. The position contributes to effective customer service and supports coordination with internal teams and external vendors to maintain accurate member coverage. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintain current knowledge of assigned benefit plan(s) and applies plan...

Position Summary The Contribution Accounting Processor 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 outgoing contribution reports; reconciles reports to payments. Researches discrepancies, credits, retro-payments and problems; contacts employers regarding discrepancies. Submits deposits, requests stop...

Position Summary The Supervisor, Claims provides daily leadership and supervision to a Claims 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 Company 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; provides oversight of processing activities to ensure compliance. Optimizes workflows/processes, tools, and staff allocation to ensure efficient and cost-effective day to...

Position Summary The Manager, Customer Care provides direction, leadership and oversight to Customer Care team(s) in accordance with Company guidelines, 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 Provides daily leadership and supervision to Customer Care team(s) consistent with management values and mission. Develops staff through performance management, goal setting, training, and effective employee relations. Optimizes workflows/processes, tools, staff allocation, and technology to ensure efficient and cost-effective day to day operations. Remediates escalated issues, reviews plan changes, and attends to other client needs. Participates in new business presentations and client meetings as requested, attends benefit fairs, and assists in the implementation of new clients. Resolves...

Introduction Zenith Agribusiness Solutions is committed to helping California's agricultural businesses succeed by providing insurance solutions that protect their operations, property, and livelihoods. With a deep understanding of the unique needs of farms and agricultural businesses, we combine industry expertise with responsive, personalized service to help our customers protect what matters most. Collaboration, work-life balance, and integrity are at the center of how we work. As part of Zenith, we support career advancement through ongoing learning and development. An individual joining our team will receive competitive compensation, a comprehensive benefits package, and continuous opportunities to grow as a professional.   This is a hybrid position based out of our Roseville, CA office . Candidates should live within commuting distance and be comfortable working onsite in accordance with Zenith’s hybrid schedule.   Candidates must be authorized to...

Introduction Zenith is a team of Workers' Compensation Specialists committed to helping businesses succeed by protecting against the financial and human consequences of workplace injuries, providing for the needs of injured employees and making the workplace safer. To distinguish ourselves as the desired provider of Workers' Compensation Insurance, values such as collaboration, work-life balance, and integrity are placed at the center of all our operations. In addition, Zenith supports career advancement through a dedication to ongoing learning and development. An individual coming to Zenith will not only receive competitive compensation and a comprehensive benefits package, but continuous opportunities to grow as a professional. Overview This individual will join the team that is responsible for civil litigation that arises from the P&C (Agribusiness) division of Zenith, and will NOT be involved in Workers Compensation...

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 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 and...

Position Summary Writes requirements for minor software development items and performs testing, in accordance with Company guidelines, client needs and legislative requirements. “Position requires access to Personally Identifiable Information and/or Personal Health Information to complete job requirements.” Key Duties and Responsibilities Analyzes programming changes and/or system enhancements to existing programs; tests and verifies the accuracy of program changes. Tests programming changes due to bug fixes, enhancements, development, and version upgrades. Collaborates with programmers to drive quality output. Analyzes data files and identifies issues. Writes requirements for minor software changes; coordinates changes with vendors and clients. Designs, generates, and evaluate reports, queries, data, and procedures on systems, including scheduling and distribution of forms and mailings for daily, weekly, monthly, annual, or other periodic processes. Assists in...