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Health Care, IT/Project Managers, Logistics/Transportation, Business/Management

Title	Business Analyst
Categories	Business/Management
Job Information	Responsible for providing a high level consulting services to client personnel. Advises client on complex issues involving new regulation, technology or system functionality. Essential Duties and Responsibilities: • Prepares estimates of resources needed to complete activities and projects. • Manage projects or project sub-plans by developing, coordinating and controlling the steps necessary to carry out a project within established time frame, budget, quality and requirements. • Investigates client needs, regulations, and technology to provide input into the design of a new system, system enhancements, or acquired software or hardware. • Elicits and clearly defines client needs by assessing and documenting business opportunities, benefits, risks, and success factors of potential business solutions. Conducts business assessment reviews and walkthroughs for complex projects. • Prepares and updates written material and explanations to accompany systems, programs, and program changes. • Works directly with a client to solve problems or make decisions requiring technical expertise or specialized knowledge. • Provides complex and/or specialized programming support to various short and/or long term clients. • Writes specialized/customized programs using multiple or complex languages. • Makes coding changes that impact system architecture/functionality. Writes programs for major application enhancements. • Coordinates and executes testing for multiple, major applications. Develops and coordinates training for client personnel. • Evaluates and documents the performance of tested software and the quality testing process to provide feedback to project team and management for current and future reference. • Provides vendor relations and client support, training and testing within the area of expertise (e.g., client/server architecture, deposit solutions). • Defines business requirements for interface screen design and conversion methodology. • Performs other related duties as assigned. Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Complexity of Work: Non-routine; general policies applied to frequently changing situations. Education: Bachelor’s degree from a four year college or university in a related field. Experience: 5-7 years professional level experience including 2 years in client relationship management and project management and/or a technical field (e.g., programming, telecom/network, and client/server); or equivalent combination of education and experience.
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Title	Claims Analyst
Categories	Logistics/Transportation
Job Information	Primary job is to recoup identified claim overpayments by generating refund requests to providers. Coordinate the posting of refunds received and identify how the refunds are to be posted to the claims. Responsible for tracking outstanding money still owed and the refunds received. Position Responsibilities: •Review overpaid claims in order to generate appropriate refund letters to the providers. Ensure the refund requests are generated in a timely and accurate manner. •Determine what money has been paid versus still owed and coordinate the claim offsetting process as appropriate •Review refunds received and determine how the money is to be posted to the claims detail lines. •Coordinate the offsetting process with future claims in order to recoup all money owed •Track all money owed and refunds received by project. Skill Requirements and Preferences: •General understanding of claims processing •Strong written and oral communication skills •Can effectively communicate with the other key areas in the organization and to providers •Strong organizational skills •Can handle multiple priorities •Analytical and reasoning skills required •MS Word and Excel knowledge
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Title	Internal IT Support
Categories	IT/Project Managers
Job Information	Duties and responsibilities for the position include, but are not limited to: • Performs troubleshooting of hardware and software issues • Properly documents issues and resolutions • Configures hardware and software on multiple Windows platforms • Processes internal computer support requests • Escalates issues according to established procedures and guidelines • Assists with the implementation of new hardware and software • Performs all other duties as assigned Requirements: All interested candidates will meet the following position qualifications: • 1 – 3 years of related experience • Experience with PC hardware and software, including Windows 2k, XP, Vista, and MS office • Excellent communications skills, both written and verbal, are essential • Must be able to effectively relay verbal instructions to end users who have varying levels of computer experience • Must be willing to work flexible schedule • Schedule could include occasional weekend and holiday hours
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Title	Call Center Team Manager
Categories	Health Care
Job Information	Health Care industry experience is preferred. Bilingual professionals are greatly desired. The Member Services Team Manager is responsible for the development, implementation, enhancement and support of call center systems, technologies and strategies. Oversees the daily operations of all Member Services Department functions; ensures activities run smoothly and efficiently; promotes the image of the company in a professional and positive manner; provides supervision, guidance, coaching, recognition, motivation and training to department personnel; participates in marketing campaigns and product launches; attains sales, quality control and customer service goals. Performs direct supervisory duties of department staff and coordinates staff for coverage in all related areas. Position Responsibilities: • Daily supervision of a team to meet departmental and corporate objectives to ensure that all member, provider and prospect inquiries and issues are resolved in timely manner • Works with management to assure that team is properly staffed based on daily and hourly schedules daily and hourly to meet variable inbound and outbound call volume demands • Provides management oversight to assure that team members are in adherence with established departmental schedules and company policies • Monitors and evaluates inbound/outbound calls and provides coaching to improve service quality, performance and productivity • Provides ongoing performance feedback and formal team member evaluations • Intervenes and takes escalated calls to answer and resolve questions and issues • Monitors call queues and staffing to assure that member calls are answered within the established service levels for the team and call center • Assures that team members have access to the systems and tools necessary to provide member related services • Assures that team member provide all call center services in compliance with regulatory and business policies and procedures • Identifies and recommends process improvement opportunities to improve productivity, performance and customer satisfaction • Other duties as assigned
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Title	Call Center Representative
Categories	Health Care
Job Information	Health Care industry is preferred. Bilingual professionals are greatly desired. Position Responsibilities: • Handle inbound customer calls or e‐mail requires for assigned customer, providing a single point of contact for the specific transaction or issue • Act as the single point of contact for assigned members in order to facilitate and/or expedite interactions within the company • Initiates customer contact to ensure satisfaction with service provided • Thoroughly researches assigned ticket issues and takes appropriate action to resolve and meet turnaround time requirements and quality standards • 80%+ amount of time spent telephonically • Develop tickets requiring additional information in order to make a final determination on the disposition • Update and maintain information in Fortuna account database • Assist management with special projects, as needed • Other duties as assigned Skill Requirements and Preferences: • Experience/knowledge of healthcare industry, preferred • Ability to identify problems, analyze alternative solutions and take action necessary to resolve issue • Good organization skills • Good diction, voice quality and clarity of speech • Must be able to communicate effectively through oral and written methods to members, providers and internal customers • Ability to work flexible schedule • Ability to work overtime as necessary
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