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Provide professional and effective technical support to a high volume of end users on systems and applications at the 1199SEIU Funds Monitor production jobs for QNXT, Vitech, Oracle EBS and Employer Portal systems Create and maintain TIDAL jobs for QNXT, Vitech, Oracle EBS and Employer Portal operations; respond to requests and escalate when necessary to the appropriate support group Debug or alte
Posted 5 days ago
Calculate various pension applications, estimates and re calculations Process inquiries for pension applications, pension estimates, and return to work Verify, establish and re establish pension member eligibility for new or existing members, spouses and dependents using the system of choice (Imaging System, V3) Maintain updated records and files on all pension claims, applications, estimates and
Posted 5 days ago
Use industry criteria, benefit plan design, clinical knowledge, and critical thinking to assess, plan and provide, ongoing coordination and management of service delivery through an integrated case management approach Provide comprehensive telephonic case management to targeted population who are at risk for admission and to medically complex patients to develop a tailored plan of care that suppor
Posted 8 days ago
Oversee daily retiree and pension related inquiries; provide guidance for reviewing and interpreting results of the eligibility nightly batch and control reports; audit control reports daily Prepare monthly HIP/HUMANA auto enrollment EDI files and process response file in the Eligibility system (Vitech V3); prepare weekly EGWP file Conduct monthly reconciliation for HIP, HUMANA and EGWP; update V3
Posted 9 days ago
Review accuracy of Coordination of Benefits (COB) information in Eligibility processing system at the 1199SEIU Benefit and Pension Funds Audit and distribute work; provide training to staff as needed Research and update COB processing systems and information Communicate with members and other professionals via telephone or by written correspondence regarding COB information (i.e. self employed, ot
Posted 12 days ago
Review and authorize pension benefits for retired 1199SEIU members, surviving spouses, beneficiaries and their estates; ensure benefits are processed in compliance with Federal and Plan regulations Verify pension calculations and medical benefit entitlements for members who receive counseling; ensure members are informed of accurate pension and medical benefits due to them upon retirement Maintain
Posted 12 days ago
R esponsibilities Review and process college scholarship documents in accordance with 1199SEIU Benefits and Pension Fund eligibility guidelines and Child Care Corporation (CCC) policies and procedures Perform data entry of all scholarship applications Respond to member's application and inquiries verbally (via the call center), in person and in writing Assist in preparation of various reports for
Posted 12 days ago
Serve as a resource for Alicare, Member Services and Eligibility department to resolve Paid Family Leave (PFL) claim questions and issues. Conduct calls to members and employers to obtain information. Research and review Eligibility response filed daily and troubleshoot questionable responses Maintain a log of issues and their status regarding PFL claims processing and administration . Including m
Posted 12 days ago
Maintain HIPAA compliance while communicating with 1199SEIU members and advocates via telephone or written correspondence regarding benefit eligibility and claim submissions; accurately and professionally respond to a high volume of calls and inquiries by providing excellent customer service Respond to outbound inquiries which include voicemails and emails Provide assistance with medical and pensi
Posted 13 days ago
Case management of nursing students enrolled in major concentration of nursing programs Contact members via telephone, in person, including one on one support in admissions center, at Training Employment Fund (TEF) sites, online, at health care facilities and at other academic events as needed; informing members of TEF academic and support services such as tutoring, review for licensure and employ
Posted 13 days ago
Utilize Statistical Analysis Software (SAS) to examine large claims data sets to trend existing provider billing patterns as compared to industry standard coding regulations with recommendations of industry standard coding logic, business rules and configuration Perform comprehensive maintenance review on all HCPCS codes (5750 codes) in which the 12 categories of codes will be examined which requi
Posted 13 days ago
Provide administrative and program support to the Assistant Director and Program Manager in the workplace skills department of the Training and Upgrading Fund TEF) Manage calendars; arrange appointments, meetings, and conferences to ensure efficiency of all departmental processes Maintain and track expenses and balance budget information using various systems, such as Microsoft Excel and Shared Tr
Posted 13 days ago
Assists in maintaining database and updating member information Serves as source of information for members and staff on Anne Shore Program Screens telephone calls and facilitates follow up, create an maintains programs calendars, schedules and database information Prepare weekly numerical reports regarding enrollment and attendance Initiates and provides follow up with members, internal and exter
Posted 15 days ago
Supervise the daily operations of a Learning Center for adult learners registered in a variety of learning programs, under the guidance of the Site and Program Managers Recruit, train, allocate work, and offer guidance and support to volunteer tutors who provide tutoring services to adult learners Assess specific learning needs of Learning Center users and identify how best to address them Develop
Posted 15 days ago
Administer the Fund's Right to Reimbursement and Subrogation in Third Party Lien and No Fault cases; oversee the recovery of benefits paid by the Fund in Workers' Compensation Cases Review and approve lien reductions based on established guidelines in Third Party Lien policy, negotiate the Fund's reimbursement with attorneys and members, respond to inquiries, initiate benefit suspension process as
Posted 16 days ago
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