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🕒 April 29

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Western Growers

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1926

🌾 Agriculture

📋 Compliance

Agriculture • Insurance • Compliance

Western Growers is an organization dedicated to supporting family farmers in Arizona, California, Colorado, and New Mexico who grow fresh produce. They provide a comprehensive range of services to enhance the economic outlook of farmers, protect their farmworker partners, and maintain a commitment to producing and supplying fresh, healthy produce. Western Growers advocates for fair legislation and regulations that benefit the agricultural community and offers innovative risk management solutions through their insurance services. Additionally, they engage in food safety, sustainable resource management, and offer a variety of educational and advocacy resources to support their members and the broader agriculture industry.

📋 Description

• plan code new business and plan changes • verify new and existing plans loaded on the company’s claim management system against the appropriate Summary Plan Description to determine the accuracy of present and future claims payments • respond to work orders received from examiners to investigate plan issues and irregularities • evaluate testing requests for all new plans prior to loading them into the production system • keep a detailed log of open and completed work • document resolutions to closed work orders • identify inefficiencies within the established processes and suggest possible solutions to save time, reduce risk, and/or reduce expenses • create and document a minimum of one new Standard Operating Procedure (SOP) annually • identify, initiate and implement at least one process improvement and/or innovation annually • maintain detailed log of plans that are currently being coded and in the process of being loaded • send confirmations to internal stakeholders when applicable plans have been loaded • work with programmers to test claims and related system programs to verify impact within the Health Care Processing System (HCPS) • utilize all capabilities to satisfy one mission — to enhance the competitiveness and profitability of our members

🎯 Requirements

• BS/BA degree in computer science, business or related field • minimum of two years of experience as a pharmacy, medical, dental claims auditor and/or plan testing experience, preferred • exceptional ability to interpret summary plan descriptions of employee medical, dental, pharmacy benefits • strong ability to work efficiently and effectively in a multiple task, multi-project, and multi-demanding environment to meet expected goals, dates, and milestones • excellent writing, editing, and proofreading skills to compose and edit correspondence, reports, emails, and other written materials • superior ability to analyze and interpret group health benefits provisions, administrative policies, and provider contracts • advanced skills in Microsoft Office applications, specifically word processing and spreadsheets • demonstrated ability to analyze and comprehend complex issues, and personalities using independent judgment, leadership, tact, diplomacy, and initiative

🏖️ Benefits

• affordable health benefit solutions • flexible work arrangements • competitive compensation packages • profit-sharing