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Benefit Examiner (Boston, MA)

Benefit Examiner (Boston, MA)
Position Summary:Responsible for reviewing, analyzing and processing all claims for the focused review process, including claims that are not able to be processed and closed by Claims Operations. This position possesses strong understanding of DentaQuest administrative and contractual policies and procedures; represents DentaQuest in a professional manner at all times.
RESPONSIBILITIES:
? Supports Corporate goals for claims processing production and accuracy by assuring dental services are approved or denied in accordance with market contract eligibility requirements.
? Ensure accuracy of claims by reading and interpreting x-rays, models, photos and/or patient charts for necessity.
? Manage questionable claims that require clinical expertise in the decision process by referring to a consultant for further review and final decision.
? Support eligibility process by approving dental services that meet eligibility requirements and deny those that are ineligible. Ensure completeness by requesting any additional information from provider offices when appropriate and communicating outcomes to providers and/or members.
? Determine eligibility and disallow and/or deny claims by following administrative guidelines.
? Works with level II benefit examiners to learn the claim processing rules in addition to becoming proficient on the claims systems and gaining an understanding of processing of claims.
? Provide customer service support by offering services as required within DentaQuest. May include assisting other departments in resolving inquires or complaints into specific claims or having direct contact with providers and/or members.
? Support UM Manager efforts by tracking and reporting results of focused review claim process, reporting of aberrant billing patterns and/or behaviors of providers and assisting in analysis of statistical data as requested.
? Improve processes and productivity of company by communicating with management.
? Design and meet personal developmental goals by accepting training and guidance.
Requirements:
* ? High School Diploma or equivalent.
* ? 5 years experience as a dental assistant or a degree in the dental field and 2 years experience with dental insurance coding.
* ? Ability to interact in a cooperative, professional and effective manner with Provider offices, members, co-workers and company staff through all mediums (phone, in person, etc.).
* ? Good communication, verbal and interpersonal skills.
* ? Ability to work independently.
* ? Good PC skills.
* ? Ability to prioritize and organize multiple tasks and remain organized with multiple interruptions.
* ? Ability to communicate via telephone.
Job Code:UM
Location:DentaQuest Ventures, MA
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Benefit Examiner (Boston, MA)

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Mentor for LEAF Program Interns

Mentor for LEAF Program Interns
Job ID:
39757
Location:
Massachusetts
Full/Part Time:
Full-Time
Regular/Temporary:
Temporary
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OFFICE LOCATION
Sheffield, Massachusetts (MA) & Martha s Vineyard, Massachusetts (MA)
ABOUT US
The Nature Conservancy is the world s leading conservation organization, working in all 50 states and more than 33 countries. Founded in 1951, the mission of The Nature Conservancy is to preserve the plants, animals and natural communities that represent the diversity of life on Earth by protecting the lands and waters they need to survive.
TNC
ESSENTIAL FUNCTIONS
The Leaders in Environmental Action for the Future Program is a month-long internship which provides students from Environmental High Schools with the opportunity to work alongside The Nature Conservancy staff on field-based projects. The mentor s two primary responsibilities are: to serve as the liaison between Nature Conservancy staff and high school students participating in the program; and to help the students make the most out of their experiences. For the duration of the program mentors are required to live with the students at Conservancy provided housing and are responsible for building a cohesive team, facilitating communication and dealing with Nature Conservancy staff on any disciplinary issues that may arise. Mentors and students assist Nature Conservancy staff in various site management projects (i.e. trail maintenance, habitat management, exotic species control, ecological monitoring, etc.) at chapter preserves and ecologically significant sites in one of over 20 states across the country. In addition teams may be required to work in the chapter office and with other Nature Conservancy staff. Mentors serve as the go between with students and The Nature Conservancy, explaining various tasks, motivating students and facilitating communication amongst the team. Mentors are expected to serve as role models, taking an active part in work and activities that students and Nature Conservancy staff perform. Mentors are given one day off each week that will be coordinated with site-based staff. Mentors must be present for all evenings (including days off) and are required to work all weekends-should the need arise, mentors may be required to transport teams from home-base to the work site and back on days off. Mentors work with the team to plan various academic and recreational activities for the weekends including a minimum of three college visits.
This position also requires satisfactory completion of a criminal background check. Candidates offered positions will be provided with an authorization form and employment will be contingent upon the results of a background check.
DUTIES
* Attend residential orientation and training sessions held from June 29-July 3, 2012 (in addition to the July 9-Aug 3 dates).
* Act as the mentor and chaperone for a team of three or four high school interns. Strive to create a cohesive functioning team. Work with students and Conservancy staff to plan leisure activities, including but not limited to, 3 college visits and recreation activities (hiking, camping, canoeing-activities students cannot easily enjoy in the city). Guide students in journal writing and in preparation of final project and final essay. Ensure compliance with Nature Conservancy rules and regulations and work with Nature Conservancy Staff to resolve any issues that arise.
* Assist chapter stewards in various site management projects at the chapter preserves (trail maintenance, habitat management, biological and botanical monitoring, exotic species control, etc.) Motivate students to participate fully in all projects.
* Communicate with the chapter stewards and assist in explaining the work to the interns. Proactively seek feedback from Nature Conservancy staff on student/team performance and concerns. Relate concerns of students and Nature Conservancy staff to one another. Facilitate weekly team meetings and mid-term evaluation process.
* Assist interns in managing budgets, buying groceries, cooking meals and other general housekeeping responsibilities. Facilitate equitable division of "household" chores.
* Facilitate communication among team members and help resolve any problems that may arise between the interns or between interns and Nature Conservancy staff. Assist in conflict resolution and inform Nature Conservancy Chapter staff of any potential issues before they arise. Seek assistance in resolution when necessary. Participate in weekly conference calls with fellow mentors and Nature Conservancy Staff.
* Fill out necessary paperwork, including tracking expenses, to ensure proper administration and evaluation of the program.
BASIC QUALIFICATIONS
* BA/BBS/AS/Technical or vocational degree and 1 year related experience or equivalent combination of education and experience.
* A minimum of 2 years experience working with urban high school students and familiarity with basic principles of positive youth development.
* Experience supervising staff.
* Experience performing physical outdoor work.
PREFERRED QUALIFICATIONS
* Experience working with high school students. Teaching experience preferred.
* Experience working out-of-doors, tolerance of long hours out-of-doors and strenuous activities.
* Ability to work out-of-doors, in all weather conditions and, at times, on difficult or hazardous terrain (e.g. steep slopes, wetlands, heavily forested or scrub land, etc.).
* Ability and willingness to drive long distances.
* Good team player with flexibility, strong communication skills, and a sense of humor.
* A valid driver s license.
* First aid training preferable-if not currently certified, training will be provided at The Nature Conservancy s expense.
* Must be available to interview in person in the area.
ADDITIONAL JOB INFORMATION
* This position begins on July 9, 2012 - August 3, 2012
AUTO SAFETY POLICY
This position requires a valid driver s license and compliance with the Conservancy s Auto Safety Program. Employees may not drive Conservancy-owned/leased vehicles, rental cars, or personal vehicles on behalf of the Conservancy if considered "high risk drivers." Please see further details in the Auto Safety Program document available at www.nature.org/careers.
Employment in this position will be contingent upon completion of a Vehicle Use Agreement, which may include a review of the prospective employee s motor vehicle record.
TNC
BENEFITS
The Nature Conservancy offers competitive compensation, excellent benefits, flexible work policies and a collaborative work environment. We also provide professional development opportunities and promote from within. As a result, you will find a culture that supports and inspires conservation achievement and personal development, both within the workplace and beyond.
TNC
SALARY INFORMATION
* $3,600 paid bi-weekly. Travel is required and paid by The Nature Conservancy, including rental car, lodging, first-aid training, and stipen for group meals, travel and recreation
HOW TO APPLY
To apply to position number 39757, submit resume and cover letter as one document.
All applications must be submitted in the system prior to 11:59 p.m. Eastern Time on March 3, 2012.
Failure to complete all of the required fields may result in your application being disqualified from consideration. The information entered in the education and work experience sections are auto screened by the system based on the basic qualifications of the position.
You must click submit to apply for the position. Click save if you want to be able to return to your application and submit it later. Once submitted, applications cannot be revised or edited.
EOE STATEMENT
The Nature Conservancy is an Equal Opportunity Employer.
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Mentor for LEAF Program Interns

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Production Planner

Production Planner
Division Geospatial Systems
Work Location MA, West Springfield
About ITT Exelis ITT Exelis is Powered By Ingenuity, which is the hallmark of our business, products and people. We provide innovative solutions in the areas of command, control, communications, computers, intelligence, surveillance and reconnaissance (C4ISR). Working at ITT Exelis, you will join the ranks of 20,000 employees serving our customers around the globe. At ITT Exelis, our workplace culture encourages a spirit of adventure and encompasses a can-do attitude. We place emphasis on building and sustaining a diverse workforce which is inclusive of different perspectives and varied business, academic, cultural and social backgrounds.
Job Description A planner is responsible for converting customer orders in conjunction with sales forecasts into an achievable production schedule that will meet customer ship dates. Devise a production schedule based on inventory and manpower availability. Communicate production schedule to Operations Team. Establish monthly shipping plan and coordinate execution of plan. Maintain visibility of overdue jobs, analyze and develop recovery schedule with affected parties and effectively communicate changes to production schedule to Operations Team, Engineering, Quality, and Customer Service to ensure timely product delivery in a cost effective manner.
Specific duties of a planner include forecasting future demand of products, creating a future fulfillment plan, plan and prepare production schedules for assigned products. Work with Production Supervision in machine loading & job sequencing to enable manufacturing to meet production requirements & maintain customer service levels. Works with the Production Manager in Capacity Requirements. Assure manufacturing lead-time control, accuracy & reliability. Draw up manufacturing method master schedule to establish sequence & lead-time of each operation to meet shipping dates according to sales forecasts or customer orders. Analyze production specs & plant capacity data & perform mathematical calculations to determine manufacturing processes, tools, and human resources requirements. Plan & schedule work flow for department operations according to established manufacturing sequences & lead times. Maintains job-related data and reports. Continuously strive to improve systems, tools, automation, and procedures in the Planning and Scheduling areas. Provides other departments with production completion forecasts when required. The production planner should have a good knowledge of working with databases, collecting and disseminating information, preparing reports and keeping all parties informed of any changes in scheduling or production.
Duties and Responsibilities:
1.Plans and prepares production schedules for manufacture of industrial or commercial products: Draws up master schedule to establish sequence and lead time of each operation to meet shipping dates according to sales forecasts or customer orders.
2.Coordinate and expedite the flow of work and materials within or between departments of an establishment according to production schedule.
3.Review and Distribute production work, and shipment schedules; conferring with department supervisors to determine progress of work and completion dates; and compiling reports on progress of work, inventory levels and production problems.
4.Provide timely forecast information to purchasing to facilitate on time delivery of raw maerials & reduce expediting costs.
5.Analyze production specifications and plant capacity data and perform mathematical calculations to determine manufacturing processes and human resource requirements.
6.Plans and schedules workflow for each department and operation according to previously established manufacturing sequences and lead times.
7.Plans sequence of fabrication, assembly, and other manufacturing operations for guidance of production workers. Confers with department supervisors to determine status of assigned projects.
8.Expedites operations that delay schedules and alters schedules to meet unforeseen conditions.
9.Prepares production reports and maintain job-related data and reports
10.Analyzes and interprets construction of bills of material, scopes, specifications, etc., to determine the content & plan manageable work elements.
11.Launches defined work packages, including instructions, drawings, bills of material, references, inspection requirements, etc., to initiate and control production work.
12.Monitors, analyzes & reports performance to schedule of production & production support activities, utilizing information derived from material and production control systems.
13.Ensures all parties are fully cognizant of production status and that the planning and execution objectives are integrated & communicated.
14.Resolves problems utilizing acquired knowledge & analytical abilities.
Required Experience:
1. Experience in Excel and/or Access
2. ERP implementation experience, SAP Experience Preferred
3. Warehouse and Inventory control experience?
4. Previous use of MRP - ERP systems and demand forecasting software
5. Well developed analytical and problem solving skills?
6. Self starter with the ability to manage multiple tasks at one time
7. Ability to communicate and work with all internal departments as required
8. Ability to demonstrate flexibility when faced with frequent operational changes
9. Good judgment & decision making skills and knowledge of time management principles.
10. Minimum of 3-5 years experience in a production planning / master scheduling role MRP/ERP systems, databases and spreadsheets is required
11. Ability to perform tasks while maintaining ITT Values (Respect, Responsibility & Integrity)
Desired Skills: Applicants selected will be subject to a government security investigation and must meet eligibility requirements for access to classified information, US Citizenship required.
We are committed to an inclusive and diverse workplace that values and supports the contributions of each individual. This commitment along with our common Vision and Values of Respect, Responsibility, and Integrity, allows us to leverage differences, encourage innovation and expand our success in the global marketplace.
Clearance Level Required No Clearance Required
Minimum Education Requirements High School or Equivalent
Percent of Travel Required N/A
Work Status Full-Time
EEO Statement We are committed to an inclusive and diverse workplace that values and supports the contributions of each individual. This commitment along with our common Vision and Values of Respect, Responsibility, and Integrity, allows us to leverage differences, encourage innovation and expand our success in the global marketplace. "
ITT Exelis is an Equal Opportunity/Affirmative Action Employer. M/F/D/V.
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Production Planner

Sales Representative - Solution Sales - Senior (Building Automation Systems)

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Company Schneider Electric Buildings
Job Title Sales Representative - Solution Sales - Senior (Building Automation Systems)
Location USA - MA - Andover
Req. # 27620
Job Function Sales
Job Responsibilities This position is the primary sales position within the organization responsible for identifying, estimating and selling solution-based projects. Position is responsible for using excellent product and customer knowledge to educate customers on pricing and application competitive advantages and how they meet the customer s needs. This position is responsible for developing and maintaining relationships with new and existing customers to identify the scope of work, estimate and sell systems and solutions to meet or exceed his/her booking and booked gross margin budgets. This position is also responsible for maintaining a post-sale relationship.
1. Sells systems solutions to executive level decision-makers.
2. Prospect for, identify, and qualify potential sales opportunities.
3. Cultivate, develop and maintain long-term customer relationships.
4. Write specifications or RFQs for customer.
5. Develop and implement sales strategies and tactics for individual sales opportunities.
6. Prepare and deliver audit reports and proposals.
7. Generate and implement sales presentations.
8. Process and analyze feasibility assessments and/or all bid/contract documents.

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Sales Representative - Solution Sales - Senior (Building Automation Systems)

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Sales Representative - Solution Sales - Senior (Building Automation Systems)

<--- Previous Job Next Job --->
Company Schneider Electric Buildings
Job Title Sales Representative - Solution Sales - Senior (Building Automation Systems)
Location USA - MA - Andover
Req. # 27619
Job Function Sales
Job Responsibilities This position is the primary sales position within the organization responsible for identifying, estimating and selling solution-based projects. Position is responsible for using excellent product and customer knowledge to educate customers on pricing and application competitive advantages and how they meet the customer s needs. This position is responsible for developing and maintaining relationships with new and existing customers to identify the scope of work, estimate and sell systems and solutions to meet or exceed his/her booking and booked gross margin budgets. This position is also responsible for maintaining a post-sale relationship.
1. Sells systems solutions to executive level decision-makers.
2. Prospect for, identify, and qualify potential sales opportunities.
3. Cultivate, develop and maintain long-term customer relationships.
4. Write specifications or RFQs for customer.
5. Develop and implement sales strategies and tactics for individual sales opportunities.
6. Prepare and deliver audit reports and proposals.
7. Generate and implement sales presentations.
8. Process and analyze feasibility assessments and/or all bid/contract documents.

More Information »

Sales Representative - Solution Sales - Senior (Building Automation Systems)

<--- Previous Job Next Job --->
Company Schneider Electric Buildings
Job Title Sales Representative - Solution Sales - Senior (Building Automation Systems)
Location USA - MA - Andover
Req. # 27619
Job Function Sales
Job Responsibilities This position is the primary sales position within the organization responsible for identifying, estimating and selling solution-based projects. Position is responsible for using excellent product and customer knowledge to educate customers on pricing and application competitive advantages and how they meet the customer s needs. This position is responsible for developing and maintaining relationships with new and existing customers to identify the scope of work, estimate and sell systems and solutions to meet or exceed his/her booking and booked gross margin budgets. This position is also responsible for maintaining a post-sale relationship.
1. Sells systems solutions to executive level decision-makers.
2. Prospect for, identify, and qualify potential sales opportunities.
3. Cultivate, develop and maintain long-term customer relationships.
4. Write specifications or RFQs for customer.
5. Develop and implement sales strategies and tactics for individual sales opportunities.
6. Prepare and deliver audit reports and proposals.
7. Generate and implement sales presentations.
8. Process and analyze feasibility assessments and/or all bid/contract documents.

More Information »