Resource Settlement Services Jobs in Usa

Hybrid: Applicants must be a California resident as of their first day of employment.

PRINCIPAL RESPONSIBILITIES:

Member Services Representatives (MSR) are the first point of contact for our members' primary contact with the Alliance for both routine and complex member issues with the goal of delivering excellent customer service to our customers. The position is responsible for answering a high volume of inbound and outbound calls in a timely manner. Respond to all communications coming into Member Services in the form of email, fax, letters, chat and phone calls. Timely responses to all member communication are essential. Must effectively prioritize and flex the workload as new communication and tasks are submitted. Identify the caller's needs, clarify information, research issues, and provide solutions and/or alternatives whenever possible. Accurately and consistently document all conversations in the electronic database. This position is a liaison between the plan, the provider network, and other community agencies. The MSR positions are flexibly staffed classification and work is expected to be performed minimally at the MRS II level. However, the initial selection will be made at the entry level MSR I. Our more advanced level position of the series is the MSR III who will be required to perform a variety of complex matters.

Member Services Representatives are under the direction of a Member Services Supervisor, Manager and Director, and service our members through our call center as well assisting other departments with responses to member issues by initiating communication between departments to ensure action, cooperation, and compliance of managed care operations.

Member Services Representative I

This position which requires the ability to work as a team player within the Alliance and with external contacts, make sound judgments based on analysis of information, be an effective communicator, active listener and balance advocacy for the member with the policy provisions such as plan policies, EOC, regulatory guidelines, and DMHC/DHCS rules and regulations. The MSR provides courteous, professional, and accurate responses to incoming inquiries regarding network, plan benefits, eligibility, authorizations, plan services and guidelines, as well make decisions with the goal of ensuring member satisfaction and retention. The MSR performs a variety of complex functions and is also responsible for maintaining accurate and complete inquiry/grievance records in the electronic database. Maintains compliance with DMHC regulatory requirements and DHCS contractual obligations. MSR I staff who demonstrate proficiency in meeting, maintaining and exceeding principal performance objectives and metrics may be eligible to be promoted to a Member Services II or III role. Member Services Representative I staff may be eligible for promotion to Member Services Representative II or III positions once they have worked as a MSR I for a minimum of 12 months to be proficient with program and system knowledge in addition to meeting performance matrix requirements.

Principle duties and responsibilities

* Serve as the primary contact for members, providers and others for questions related to claims, benefits, authorizations, pharmacy, member eligibility and other questions related to Alameda Alliance and provide accurate, satisfactory answers to their inquiries or concerns.

* Respond to and resolve member service inquiries and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility, claims, behavioral health, and care coordination.

* Answer incoming calls, emails, chats, and other requests for assistance in a timely manner in accordance with departmental performance targets and provide excellent customer service while doing so. May include assisting members in person.

* Recognize and understand the difference between calls that require quick resolutions and calls which will require follow-up and handle each appropriately.

* De-escalate situations involving dissatisfied customers, offering patient assistance and support.

* Accurately document all contacts per department standards/guidelines in the Customer Relationship Management (CRM) system.

* Accurately and consistently document (electronic database) and resolve Exempt Grievances (any expression of dissatisfaction that are not coverage disputes, disputed health care services involving medical necessity, or experimental or investigational treatment and that are resolved by the next business day following receipt).

* Interface with Grievance and Appeals, Claims, Enrollment, IT, Network Management, Pharmacy, Authorizations, and other internal departments to provide Service Excellence to our members.

* Help guide and educate members about the fundamentals and benefits of managed health care topics, to include managing their health and well-being by selecting the best benefit plan service options, maximizing the value of their health plan benefits, and choosing a quality care provider.

* Intercede with care providers (doctor's offices) on behalf of the member, assisting with appointment scheduling; connect members with internal Case Management Department for assistance as needed.

* Assist members in navigating , the Member Portal, and other health care partner online resources and websites to encourage/reassure them to use self- service tools that are available.

* Manage any issues through to resolution on behalf of the member, either on a single call or through comprehensive and timely follow-up.

* Research complex issues across multiple databases and work with support resources to resolve member issues and/or partner with others to resolve escalated issues.

* Provide education and status on previously submitted pre-authorizations or pre- determination requests for both medical and pharmaceutical benefits.

* Meet the performance goals established for the position in the areas of compliance, efficiency, call quality, member satisfaction, first call resolution, punctuality, and attendance.

* Always maintain a professional level of service to members.

* Always maintain confidentiality of information.

* Consistently support the Alliance's approach to Service Excellence by adhering to established department and company standards for all work-related functions.

* Interact positively with all Alliance Departments.

* Accurately and consistently document (electronic database) and resolve Exempt Grievances (any expression of dissatisfaction that are not coverage disputes, disputed health care services involving medical necessity, or experimental or investigational treatment and that are resolved by the next business day following receipt).

* Process MS Dept projects

* Serve as a back-up to manage the escalated calls.

* Perform other duties as assigned.

ESSENTIAL FUNCTIONS OF THE JOB

* Contacts: Receive, manage, and document telephone calls, emails, and other sources of contacts from members, potential members, and providers, and explain health plan benefits and plan rules. Describe the types of services the Alliance offers to the Member within the managed care system. Provide clarification about issues regarding patient and physician rights and how the plan operates.

* Conflict resolution: Resolve member problems/conflicts by convening with other departmental staff as needed.

* Member communications: Create and/or mail appropriate member materials and communications as needed.

* Computer: Perform ongoing data entry which assists in the maintenance of the Member Services department database to ensure data integrity.

* Comply with the organization's Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls.

PHYSICAL REQUIREMENTS

* Constant and close visual work at desk or computer.

* Constant sitting and working at desk.

* Constant data entry using keyboard and/or mouse.

* Constant use of multi-monitor setup

* Frequent use of telephone and headset.

* Frequent verbal and written communication with staff and other business associates by telephone, correspondence, or in person.

* Frequent lifting of folders, files, binders, and other objects weighing between 0 and 30 lbs.

* Frequent walking and Standing

Number of Employees Supervised: 0

MINIMUM QUALIFICATIONS:

* Bachelor's degree or equivalent experience preferred.

* High school diploma, GED required.

* The ability to speak and understand-bilingual: Spanish/English, Cantonese/English, Vietnamese/English, Tagalog/English are required as designated.

* A bilingual proficiency exam will be administered to ensure the candidate possesses the appropriate skill level to meet requirements. The successful candidate must score 90% or higher.

MINIMUM YEARS OF ADDITIONAL RELATED EXPERIENCE:

* Minimum one year of direct customer service experience. Call center experience and managed care experience a plus

* Experience determining eligibility for financial assistance, insurance benefits, unemployment and/or other social services programs.

* Demonstrated knowledge expert of AAH Member Services policies and procedures

* Consistent record of meeting, maintaining, or exceeding monthly Departmental performance metrics.

* Consistent track record of documenting Service Requests accurately and clearly and monitoring open Service Requests to ensure responses and closure.

* Consistent record of high quality of work as demonstrated through call and documentation auditing, appropriate Call Disposition coding, as well as an overall acceptable monthly Member Satisfaction Survey result as assessed by Member Services Quality Specialist, MS Trainer and Member Services Supervisor.

* Demonstrated proficiency in current Customer Relationship Management (CRM) tool, phone system software Quality Management Solution, Pharmacy Benefits Management applications (PBM), Interpreter vendor scheduling software, delegate portal solutions and the Alliance's Member portal.

* Demonstrated ability to effectively handle the department's key special projects: Member Portal Request Processing, Kaiser PTE Requests, PCP retroactive and same month requests.

* Demonstrated ability to help members face-to-face in the field and/or at the Alliance offices (walk-ins). Also highly skilled at handling issues related to member bills, transportation set-up and benefit coordination with providers and pharmacy needs.

SPECIAL QUALIFICATIONS (SKILLS, ABILITIES, LICENSE):

* Ability to prioritize and adapt to changing situations in a calm and professional manner.

* Ability to maintain composure in stressful situations.

* Excellent problem-solving skills

* Ability to exhibit cooperation, flexibility, and provide assistance when talking to members, providers, and staff.

* Skill in basic data entry

* Ability to type 40 net words per minute: multi-task

* Manual dexterity to operate telephone, computer keyboard equipment.

* Speak English proficiently, clearly, and audibly.

* Memorize and retain information quickly; meet physical requirements

* Spell correctly

* Learn the policies, regulations, and rules applicable to business operations.

* Follow instructions, reason clearly, analyze solutions accurately, act quickly and effectively in emergency situations; operate office equipment including computers and supporting word processing, spreadsheet, and database applications.

* Excellent phone etiquette and ability to communicate clearly and concisely, both orally and in writing.

* Excellent interpersonal skills with the ability to interact with diverse individuals and flexibility to customize approach to meet all types of member communication styles and personalities.

* Strong verbal and written communication skills.

* Demonstrated ability to quickly build rapport and respond to members in a compassionate manner by identifying and exceeding member expectations (responding in respectful, timely manner, consistently meeting commitments).

* Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests, and identify the current and future needs of the member.

* Must be self-motivated and able to work with minimal supervision

* Must be team-oriented and focused on achieving organizational goals.

* Proficient problem-solving approach to quickly assess current state and formulate recommendations.

* Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions which members can understand and act upon.

* Proficient conflict management skills to include ability to resolve issues during stressful situations and demonstrating personal resilience.

* Ability to work regularly scheduled shifts within the Alliance's hours of operation including the training period, with scheduled lunches and breaks, flexibility to adjust daily schedules; and to work over-time and/or weekends as needed.

* Medical terminology knowledge preferred

* Ability to work within a broad systems perspective

* Experience in use of various computer systems software as well as Microsoft Windows, and Microsoft Suite, especially Outlook, Word, Excel.

* Must have reliable and stable internet connection for remote work (50-100 Mbps download speeds).

Employees who interact with members of the public may be required to be tested for Tuberculosis and fully vaccinated against COVID-19 and influenza. Successful candidates for those positions/ classifications may be required to submit proof of vaccination against influenza and/or COVID-19, a negative Tuberculosis test, or request an exemption for qualifying medical or religious reasons during the onboarding process. Candidates should not present proof of vaccination until instructed to do so by the Human Resources department.

SALARY RANGE $22.88-$34.33 HOURLY

The Alliance is an equal opportunity employer and makes all employment decisions on the basis of merit and business necessity. We strive to have the best-qualified person in every job. The Alliance prohibits unlawful discrimination against any employee or applicant for employment based on race, color, religious creed, sex, gender, transgender status, age, sexual orientation, national origin, ethnicity, citizenship, ancestry, religion, marital status, familial status, status as a victim of domestic violence, assault or stalking, military service/veteran status, physical or mental disability, genetic information, medical condition, employees requesting accommodation of a disability or religious belief, political affiliation or activities, or any other status protected by federal, state, or local laws.

Investments HR Project Management Lead

Total Rewards, Change Management & HR Workstreams

Type: Hybrid 2-3 Days Office

Location: New York, NY 10010

Duration: 9 months (potential for extension/hire)

Must-Have Skills / Experience:

Project Management Experience (3–5 years): Build and manage project plans, build and manage status reports, lead project status meetings and other relevant project meetings, build and manage project trackers, manage project stakeholders and address/resolve issues that inhibit progress, identify risks and issues early and collaborate with workstream leads to mitigate and/or resolve them

Excel Proficiency: Strong working knowledge of Excel; experience with VLOOKUP and pivot tables is preferred.

Adaptability in Fast-Paced Environments: Proven ability to manage multiple priorities and meet tight deadlines effectively.

Overview

We are seeking an HR Project Management Lead to provide structured, strategic support across several critical HR workstreams Compensation, Benefits, Change Management, and the broader HR workstream, including the HRIS cutover for newly acquired company into New York Life scheduled for 2027.

This role serves as an integrator and executional engine for the HR project portfolio. The ideal candidate brings strong coordination capabilities, stakeholder dexterity, and the discipline needed to support high-visibility initiatives, enabling HR leaders to operate with confidence, clarity, and precision.

This individual will blend strategic insight with hands-on delivery, stepping in to drive key activities, maintain project momentum, and ensure alignment across teams.

Key Responsibilities

Program Coordination & Governance Support

Partner with HR leaders to support planning, scheduling, and monitoring activities across Compensation, Benefits, Change Management, and HRIS efforts.

Maintain project documentation, timelines, risk logs, and reporting dashboards, ensuring stakeholders have consistent and accurate updates.

Support the development and facilitation of governance routines, including steering committees, working sessions, and cross-functional checkpoints.

Total Rewards Workstream Support

Provide day-to-day coordination and operational support for Compensation and Benefits workstreams, ensuring milestones, tasks, and dependencies are accurately tracked and executed.

Provide project management support for benefit plan implementation, including coordinating among NYL technology, HRIS, benefit vendors (Alight and Empower), communication plan and review support, and onboarding a non-payroll entity.

Assist with analytical needs, documentation efforts, and preparation for design sessions, leadership reviews, and stakeholder communications.

Help identify process gaps, surface issues, and support timely resolution in partnership with Total Rewards leadership.

Change Management Support

Assist in building and executing change management deliverables—stakeholder assessments, communication plans, training coordination, and readiness checks.

Support the Change Management lead by collecting inputs, preparing materials, and tracking adoption indicators.

Help maintain alignment across HR, Communications, and impacted business areas.

HR Transformation & HRIS Cutover Support

Coordinate key activities related to HRIS cutover for a new company acquisition, including scheduling workshops, tracking deliverables, gathering requirements, and preparing documentation.

Act as a connector across HRIS, HR partners, technology teams, and business stakeholders to ensure information flows smoothly.

Support testing, data readiness, and issue tracking as part of implementation activities.

Strategic & Operational Support

Translate high-level directives from HR leadership into actionable workplans, status updates, and coordinated activities.

Provide strategic insight by identifying risks, dependencies, and opportunities for optimization.

Take a hands-on approach to execution, stepping in where needed to keep workstreams moving and support team efficiency.

Stakeholder Engagement & Communication

Facilitate communication across HR, Finance, Technology, and business teams by preparing agendas, summaries, and presentation materials.

Support escalation processes and ensure decision-makers have timely and accurate information.

Build strong, trust-based partnerships across the organization through proactive engagement and collaborative problem-solving.

Qualifications

3-5+ years of experience in program and/or project management.

Experience supporting Total Rewards, HRIS implementations, or large-scale HR initiatives highly a plus

Familiarity with change management practices (e.g., PROSCI, ADKAR) a plus.

Strong organizational skills with exceptional attention to detail.

Ability to manage multiple priorities while maintaining composure and a service-oriented mindset.

Strong communication, relationship-building, and stakeholder management skills.

Comfortable blending strategic support with hands-on execution.

Success Profile

Collaborative Partner: Operates with a service mindset and builds alignment across diverse groups.

Operational Backbone: Brings structure, organization, and disciplined follow-through.

People-Centered Communicator: Creates clarity and connection through thoughtful, empathetic engagement.

Execution-Focused: Drives progress with persistence, accuracy, and a solutions-oriented approach.

Forward-Looking Supporter: Anticipates needs, mitigates risks, and enables informed decision-making.

• The Director of BI and Data Services will be primarily managing Power BI and Epic Cogito. Preferred candidates would reside in Oregon with the ability to come onsite.

• We are open to considering candidates remote out of state in which we can employ in the following states: Alabama, Alaska, Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin

JOB SUMMARY/PURPOSE

• Oversees the design, implementation, and maintenance work of business intelligence, analytics, and data architecture managers. Responsible for the strategic leadership and direction of data architecture and business intelligence strategies to meet the data needs of the organization. Ensures system standards and compatibility with SHS information systems architecture, tools, policies, and procedures. Ensures that data initiatives align with organizational objectives and data governance policies and procedures. Responsible for budgeting of IS Business Intelligence and Data Services department, ensuring resources are allocated efficiently and cost-effectively to support the organization's goals. Leads maturation of Samaritan Health Services as a data driven, data literate health system, working with clinicians, business stakeholders, researchers, informaticists, IS colleagues, and others. Creates a culture of teaching, mentoring and professional development across the system. Maintains consultative, trusted-advisor relationships with stakeholders.

DEPARTMENT DESCRIPTION

• Information Services is committed to providing leadership, support and coordination of technology at Samaritan Health Services. The IS Business Intelligence and Data Services department provides comprehensive data support as a centralized resource for the organization. Services include data integration and warehousing, analytic reporting, business intelligence solutions, statistical data analysis, and data science solutions.

EXPERIENCE/EDUCATION/QUALIFICATIONS

• Bachelor's degree required (preferably in an Information Systems related field). An advanced degree in information systems, mathematics, statistics, analytics, engineering or a related field preferred.
• Eight (8) years professional and/or leadership experience in data analytics/business intelligence/data science required.
• Five (5) years experience in the management of technical resources required.
• Two (2) years experience in business intelligence/data science delivery required.
• Project management and continuous process improvement experience required.
• Experience with Epic Cogito strongly preffered.
• Experience in multiple data-related technologies required.
• Project management certifications preferred.
• Experience providing advanced business intelligence and data science solutions in a healthcare setting preferred.

KNOWLEDGE/SKILLS/ABILITIES

• Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
• Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
• Critical thinking – Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.
• Communication and team building – Leads effectively with excellent verbal and written communication. Delegates and initiates/manages cross-functional teams and multi-disciplinary projects.

Customer Service Support Supervisor

The Customer Support Service Supervisor is responsible for the independent oversight of all dispatch operations within their assigned service team, territory, or region. Acting as the primary point of contact within the Service Coordination group, the Supervisor ensures seamless communication among customers, technicians, and management, while delivering timely and efficient customer service. This role serves as both a subject matter expert in Customer Support Services Team (CSST) processes and a trainer/mentor for Service Coordinators and administrative staff. With minimal direct oversight, the Supervisor exercises sound judgment and decision-making authority to resolve issues, enhance processes, and ensure adherence to service and company standards.

Principal Duties and Accountabilities:

Supervision & Leadership

• Serve as the direct line of support for Service Coordinators/Administrative Assistants within the region.
• Monitor, train, and mentor Service Coordinators, ensuring clear understanding of processes, compliance, and performance expectations.
• Conduct quarterly performance reviews and routine one-on-ones with assigned team members.
• Support Operations Manager in maintaining appropriate staffing levels by communicating manpower needs.
• Participate in performance management, coaching, and the evaluation process for service staff.
• Collaborate with the Director of the Customer Service Support Team on team compensation, benefits, and feedback initiatives.
• Utilize software platforms to review team and operational reports, track goal achievement, and identify opportunities for process and performance improvements.
• Ensure accurate and compliant execution of customer portal management activities performed by the Senior Service Coordinator, providing oversight and guidance as needed. Serving as backup
• Seek approval from management before enforcing exceptions to CSST policies or taking disciplinary action.

Dispatch Operations

• Manage all aspects of dispatch operations, including scheduling, prioritization, and technician assignments.
• Maintain the service work order process—ensuring accurate client/job creation, scheduling, and tracking in the Dispatch Board.
• Monitor ongoing service work assignments and technician locations through active communication.
• Receive and process incoming customer service requests; make rapid decisions to route calls appropriately.
• Act as point of escalation for complex service issues or customer concerns.
• Utilize data and analytics to identify service trends and efficiency opportunities.
• Manage weekly payroll and timekeeping for assigned technicians, acting as back up to the Service Coordinators as needed.
• Provide backup support to Service Coordinators as needed.

Job Management

• Establish new work orders in the accounting system for both new and existing customers.
• Partner with Project Managers, Account Managers, and Technicians to ensure timely work order completion and billing accuracy.
• Ensure proper documentation and accuracy in all service-related information.

Sales Collaboration

• Partner with the Sales department by providing insights into service capabilities, scheduling considerations, and resource requirements to support customer proposals and service agreements.
• Attend site walks for new service agreements; meet directly with customers to gather and verify accurate billing information, site details, and key contact information.
• Collaborate with Sales to ensure smooth handoffs from the pre-sales process to active service delivery, helping establish realistic customer expectations and seamless onboarding.

Process Improvement & Development

• Regularly evaluate customer support and operations processes; recommend enhancement opportunities to the department director.
• Stay current with industry best practices, service software applications, and workflow optimization strategies.

Education:

• High School Diploma or equivalent required; Associate or Bachelor’s degree preferred.
• General courses in accounting preferred.

Experience:

• Minimum 4 years’ experience in a customer service-related role with exposure to operations or accounting administration.
• Minimum 3 years’ experience as a Service Coordinator or Dispatcher.
• Knowledge of commercial HVAC systems, equipment, and terminology required.
• In-depth understanding of dispatch center operations, scheduling, and resource allocation.
• Proficiency with service software systems and Microsoft Office Suite; knowledge of Access and accounting platforms preferred

Knowledge, skills, and abilities:

• Proven ability to work independently, make proactive decisions, and prioritize effectively in high-volume, fast-paced environments.
• Strong leadership and mentoring skills with ability to foster collaboration within the team.
• Excellent customer service and interpersonal skills; able to handle escalated issues with professionalism.
• Exceptional organizational skills with attention to accuracy in scheduling, records, and customer information.
• Strong problem-solving and analytical skills; ability to interpret data for improved decision-making.
• Effective verbal and written communication skills with customers, staff, and management.
• Demonstrated confidentiality and professionalism with sensitive topics (payroll, benefits, performance).
• Commitment to professional growth and the development of new skills to support evolving operational and technological needs
• Ability to adapt to changing circumstances, handle unexpected challenges, and remain composed under pressure.
• Proficiency in operating computer systems, software, and communication devices required for dispatch operations, including data entry and handling various administrative tasks.
• Capacity to analyze complex situations, identify patterns, and make informed decisions in a fast-paced and time-sensitive environment.
• Capability to handle high-pressure situations, such as managing urgent service calls or resolving conflicts, while maintaining composure and professionalism.
• Ability to quickly assess problems or issues, evaluate available options, and implement effective solutions to maintain service quality and customer satisfaction.
• Skill to make sound judgments based on available information, company policies, and customer needs, ensuring the best outcomes for all parties involved.
• Flexibility to adjust plans, schedules, and resource allocation in response to changing priorities, emergencies, or unforeseen circumstances.

Physical and/or travel demands:

• Some travel may be required.
• This position is done in a typical office setting, mostly sitting at a desk. Frequent use of computer keyboard, monitor, and telephone. Some standing, bending, and lifting light files is required.
• May require occasional bending, stooping, and lifting of files, light office equipment, etc.

Benefits and Compensation:

• The range for this position has been established at $72,000 to $101,000 per year and is U.S. Engineering - Service's good faith and reasonable estimate at the time of the posting. The compensation offered to the finalist selected for this role will be based on a variety of factors, including but not limited to internal equity, experience, education, specialty, and training. Compensation for this role includes a base salary complemented by commission opportunities based on the Account Manager’s individual sales performance and attainment of sales targets
• Your total compensation will go beyond the number on your paycheck. Team members are eligible for a year-end bonus based on company and/or individual performance as well as paid time off. An industry-leading benefits package, including health, dental, and vision plans, matching retirement contributions, and matching 529 contributions all add to your bottom line.

To apply, please visit must be legally authorized to work in the United States on a full-time basis without requiring future sponsorship for employment visa status.

U.S. Engineering - Service is an Equal Employment Opportunity Employer and shall provide equal employment opportunities to all people in all aspects of employer-employee relations, without regard to race, color, creed, national origin, religion, sex, age, sexual orientation, gender identity, disability or veteran status.

U.S. Engineering - Service is compliant with the Drug Free Workplace Act, and all offers of employment are contingent upon the completion of a pre-employment drug screen.

Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this position. They are not intended to be construed as an exhaustive list of all responsibilities and job specifications required of employees so classified. U.S. Engineering reserves the right to revise as needed. The job description does not constitute a written or implied contract of employment.

With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report, we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career!

UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:

• PPO medical plan, available day one at no cost for full-time employee-only coverage
• 100% coverage for preventive healthcare-no copay
• Paid Time Off, available day one
• Retirement Programs through the Teacher Retirement System of Texas (TRS)
• Paid Parental Leave Benefit
• Wellness programs
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF) Qualified Employer

Flexibility start time from 7am-9am thru 3:30pm-5pm. This is a remote position however, candidate must live in the Dallas Fort Worth metroplex due to occasional onsite meetings/trainings. This will be discussed more in the interview.

Experienced collector for Traditional Medicare with billing experience and EPIC knowledge a plus. Knowledge of the Medicare DDE system and able to navigate within that system. Experience correcting claims returned from the provider directly in the DDE system.

Job duties include:

• Analyze payer underpayments, variances, and denials. Escalate trends, make comprehensive suggestions, and file professional appeals according to our contractual agreements and UT Southwestern policy.
• Responsible for outbound calls and/or status inquiries via payer's website validating receipt of medical claims and adjudication status within established timeframes.
• Display competency and ability to work within client based, research, and UTSW special arrangements.
• Be knowledgeable on all payer types and effectively work on special projects for specific initiatives for account resolution projects.
• Make necessary adjustments as required by plan reimbursement.
• Function as a departmental liaison for billing and collections support for internal and external customers, as required.
• Utilize systems tools and department resources to achieve production and quality targets for resolution of patient accounts.
• Investigates and responds to questions or requests for additional information in a timely and professional manner to ensure proper, timely and accurate payment of patient accounts.
• Maintains passing QA Scores
• Attends in-services, classes and meetings related to all operations to the PFS department. Understands reimbursement of all 3rd party payers.

This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information. UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.

Kalkreuth Roofing and Sheet Metal is one of the nation's largest roofing contractors in the country and strives to maintain a progressive vision for the future. Kalkreuth specializes in complex commercial exterior envelope applications in various markets throughout the country. The company boasts an extensive project portfolio including clients in the automotive, chemical, government, education and healthcare industries. With a wealth of resources and an extensive construction industry network, Kalkreuth has the capabilities to complete any project according to specifications.

Duties & Responsibilities:

* Job site visits, measuring, and inspecting commercial and residential roofs

* Develop estimates for design-build, TFO, preventative maintenance agreements, and repairs of all roof types

* Ability to diagnose roof leaks and deficiencies on all types of roof systems

* Provide outstanding customer service to potential and existing customers

* Generate new business

* Project Management from inception to completion and timely follow-up

* Project a professional company image both in person and on the phone

* Other duties as assigned

Qualifications:

* 5 years experience in the roofing/construction industry

* Bachelor's degree preferred, but will accept construction experience in lieu of

* Previous experience with Single Ply Membrane, Built-Up Roof Systems, Shingle Roof Systems and Metal Roof Systems is required

* Proficient knowledge of Microsoft Office

* Strong organizational, prioritization and time management skills

* Excellent communication skills; both internal and external

* Ability to thrive in a fast-paced work environment

* Must possess a valid driver's license

* Proficient in all Microsoft Office applications

Benefits:

* Competitive Salary

* Medical, Dental, and Vision Insurance

* Disability (Short and Long Term Disability)

* Life Insurance

* 401(k)

* Paid Time Off

Accessibility: If you need an accommodation as part of the employment process please contact Human Resources at

Phone: 3

Email:

Equal Opportunity Employer, including disabled and veterans.

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If you want to view the Pay Transparency Policy Statement, please click the link: English

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About University Health: At University Health, we are dedicated to improving the health of our community through exceptional patient care, education, and innovation. Our team embodies a strong commitment to excellence, and we are seeking a dynamic and compassionate leader to guide our Dialysis Services team.

Position Overview: As the Executive Director of Dialysis Services, you will oversee the administration and clinical direction of all dialysis services within our health system. This includes the renal clinic, inpatient dialysis programs, outpatient hemodialysis clinics, home dialysis modalities, and jail dialysis services. You will work closely with our Medical Directors to plan, organize, and lead the growth and efficiency of our dialysis services, ensuring compliance with regulatory standards and best practices in patient care.

Key Responsibilities:

• Patient Care: Oversee the clinical services across multiple dialysis sites to ensure high-quality care in compliance with regulatory standards.
• Human Resources: Supervise and mentor a team of clinical and support staff. You will play a key role in staff development, recruitment, and fostering a positive work environment.
• Budget and Planning: Manage operational and capital budgets, ensuring efficient use of resources while meeting organizational goals.
• Policy and Procedures: Develop and update clinical and administrative policies to ensure ongoing compliance with healthcare regulations.
• Community Relations: Act as a liaison between University Health and the community, representing our dialysis services in various professional and public forums.

Qualifications:

• Education: Bachelor's degree in Nursing (required); Master's degree (preferred)
• Experience: At least 3 years of experience as a clinical nurse supervisor or director in dialysis services; leadership experience in managing multi-system dialysis operations is highly preferred.
• Certifications: Current RN license in Texas; AHA BLS Healthcare Provider or Instructor card required.
• Skills: Strong leadership abilities, excellent communication skills (Spanish/English bilingual a plus), and a dedication to patient-centered care.

Why University Health:

• Impactful Work: Contribute to the health of our diverse community by leading one of the most critical healthcare services in the region.
• Comprehensive Benefits: Competitive salary, comprehensive health plans, retirement options, and generous paid time off.
• Relocation Assistance: Moving to San Antonio? We offer relocation support to help you settle into your new role and home.

Location: San Antonio is a vibrant and growing city with a rich cultural history, a lower cost of living, and a high quality of life. With access to excellent schools, outdoor activities, and a strong sense of community, San Antonio is the perfect place to call home.