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Executive Inquiry Specialist
APWU Health Plan is seeking an Executive Inquiry Specialist to join our CEO’s office. This position provides support to the CEO and Director’s offices in the handling of inquiries.
RESPONSIBILITIES
- Conduct initial research and fact finding for executive inquiries and complaints.
- Categorize and document member complaints.
- Prepare written responses and correspondence to executive inquiries and complaints, once resolution has been attained.
- Document and review cases in the OnBase workflow management system.
- Stay up-to-date on health plan benefits.
- Perform other duties as assigned.
REQUIREMENTS
- AA degree or equivalent experience.
- Two to three years’ administrative experience.
- Strong communication and interpersonal skills.
- Analytical thinking to interpret insurance policies and claims.
- Attention to detail and accuracy in data entry.
- Excellent problem solving, organization and time-management skills.
- Excellent computer skills, including Microsoft Office products.
- Working knowledge of the claims system used by the Health Plan is desirable.
To apply
- All stated requirements must be clearly reflected in your resume or specifically addressed in your cover letter.
- Stated salary requirements (range is acceptable) are required for consideration.
- Experience in a Union environment preferred.
- No relocation assistance available.
- Must pass criminal records check and drug screening prior to employment.
EOE M/F/D/V; Drug-Free Employer
Applications Programmer I
APWU Health Plan is seeking an Applications Programmer I to join our Applications Development Department.
NATURE AND SCOPE
- This position reports to the Team Lead, Applications Development.
- This position is responsible for developing accurate and efficient computer programs adhering to established standards. The incumbent is responsible for changes/enhancements to existing systems.
- This position will interface with users and Business and System Analysts as well as vendors and subject matter experts in designing systems or enhancements or correcting defects found during uses.
- The incumbent will work with others as needed to obtain or create test data as required to validate system changes/enhancements.
RESPONSIBILITIES
- Assist in the development of computer programs including the testing of the finished program before formal testing and production turnover.
- Responsible for daily EDI review and correction for inbound transactions including but not limited to 834, 837, 277, proprietary and flat files.
- Work according to the direction of or project plans laid out by the Team Lead, Applications Development, Manager Application Development or their designee.
- Perform other duties as requested.
REQUIREMENTS
- Associates degree in related field preferred but 2 years of direct experience may be substituted.
- Familiarity and understanding of HTTP/FTP/SFTP concepts.
- Knowledge of CAQH CORE requirements, HITECH, ACA and other government mandates.
- Experience in SQL Server, Visual Studio, ASP.NET, C# and development tools for ETL a plus.
- Experience with health insurance systems, claims processing systems, financial systems, budget and expense systems and utilization systems a plus.
This is a union position.
To apply
- All stated requirements must be clearly reflected in your resume or specifically addressed in your cover letter.
- Stated salary requirements (range is acceptable) are required for consideration.
- Experience in a Union environment preferred.
- No relocation assistance available.
- Must pass criminal records check and drug screening prior to employment.
EOE M/F/D/V; Drug-Free Employer
Note to agencies
We do not accept unsolicited resumes from third-party vendors. Only resumes received from contracted agencies/vendors will be considered. Unsolicited resumes sent to APWU Health Plan will not be recognized and such agency will have no recourse from APWU Health Plan.