TEKsystems

• Provides Help Desk support to end users helping users to navigate and troubleshoot software issues, new/unfamiliar processes, and tools. • Facilitates the interaction between clients and technology providers (internal and external), working closely with technical resources and System Administrators as needed to troubleshoot problems determine solutions. • Reports and tracks incidents and enhancement requests. • Support training and testing efforts leading up to implantation, as well as changes and releases post go-live. • Document + update business processes and procedures.

• Lead end-to-end implementation execution for enterprise-level customers, ensuring alignment with customer goals and timelines (stakeholder mapping, milestone design, risk mitigation, resourcing) • Understand our platform and product capabilities to effectively communicate the value to end users and senior management • Serve as the single point of accountability for launch deliverables and cross-functional execution • Facilitate technical and non-technical meetings with customers, internal teams, and third parties • Anticipate and manage risks, dependencies, and escalations; course-correct proactively • Drive internal alignment, status reporting, and resource planning across functions • Own launch success metrics (timeliness, user adoption, quality, retention handoff) • Document process templates, playbooks, and continuous improvement insights post-launch • Train and mentor junior implementation or onboarding team members (if applicable)

• Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices • Protects patient records and audit information by ensuring compliance with HIPAA, privacy, and regulatory requirements • Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting • Verifies and ensures the accuracy, completeness, specificity and appropriateness of provider‑reported diagnosis codes based on medical record documentation • Reviews medical record information to identify complete and accurate diagnosis code capture based on CMS HCC categories • Maintains knowledge of relevant regulatory mandates and ensures activities are in compliance with requirements • Contributes to audit and production efforts to meet business demand and workload priorities • Provide written and verbal guidance on coding errors to others • Meets audit deliverables within established timelines and deadlines • Assists with special projects such as risk mitigation reviews • Serves as subject matter resource regarding the risk adjustment process and diagnosis coding for risk adjustment

• Deliver an outstanding customer experience on every interaction • Answer inbound customer calls and respond to online chat inquiries • Assist customers with password resets, account creation, and document uploads • Help members manage their accounts and navigate available services • Verify eligibility and review healthcare coverage options • Provide accurate information regarding products, services, and company policies • Investigate and resolve customer concerns in a timely manner • Diagnose issues and identify effective solutions • Handle complex inquiries while maintaining professionalism and empathy • Escalate issues appropriately when necessary • Develop and maintain expert knowledge of company products, programs, and policies • Adapt quickly to new procedures, program updates, and changing business needs • Successfully complete required training, self-study, testing, and certification programs • Ensure all communications comply with regulatory guidelines and company standards • Consistently follow established processes, policies, and procedures • Accurately enter and update customer information in internal systems • Maintain detailed records of customer interactions • Complete additional administrative tasks and special projects as assigned

• Demonstrate detailed knowledge of the clients’ plan provisions and Health and Welfare benefit enrollment • Ensure the maximum level of service is provided on every interaction • Work independently and in a team environment • Assist participants in a concierge service model • Provide high quality, proactive service • Daily management of open cases and new cases

• Respond to and resolve a high volume of IT support requests via phone, email, or chat, including password resets, software installations, and hardware troubleshooting. • Diagnose and resolve basic hardware and software issues, including operating system problems, connectivity issues, and user account management. • Utilize and contribute to the internal knowledge base for common issues and solutions. • Create, update, and close support tickets in the IT ticketing system, ensuring accurate documentation of all issues and resolutions. • Provide excellent customer service with a positive and professional attitude. • Troubleshoot and resolve customer complaints or concerns effectively. • Meet or exceed performance metrics including call handling time, quality assurance, and other assigned KPIs. • Perform other duties as assigned.

• Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices • Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements • Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting • Verifies and ensures the accuracy, completeness, specificity and appropriateness of provider‑reported diagnosis codes based on medical record documentation • Reviews medical record information to identify complete and accurate diagnosis code capture based on CMS HCC categories • Maintains knowledge of relevant regulatory mandates and ensures activities are in compliance with requirements • Contributes to audit and production efforts to meet business demand and workload priorities • Provide written and verbal guidance on coding errors to others • Meets audit deliverables within established timelines and deadlines • Assists with special projects such as risk mitigation reviews • Serves as subject matter resource regarding the risk adjustment process and diagnosis coding for risk adjustment

• Complete administrative tasks for Care Coordinator’s including: • MMIS entries of assessments • Authorization entries • Adding staff location and assignment in MnCHOICES with new enrollment • Moving contacts with group number changes of same product in Guiding Care • Member mail management • Each CC team has an assigned SS to submit activities to in Guiding Care

• Selling and enrolling retirees into appropriate insurance products including but not limited to health, prescription drug, vision, dental plans • Advising Pre-Medicare eligible recipients of their options • Providing Medicare education, conducting needs analysis, and assisting retirees in selecting appropriate plans • Customer service assistance within or outside of the sales process • Maintain highest levels of integrity, responsible, disciplined, team player, and produce quality work • Ability to consistently provide a “WOW” experience at all customer touchpoints • Meet and/or exceed key performance indicators • Handle inbound service calls by providing accurate and complete information with intent to enroll the customer • Actively manage all appointments to follow up with a prospect • Respond to voicemails within 24 hours, internal chat requests, handle complaints and/or client escalations

• This role supports Medicare members, providers, pharmacies, brokers, and internal teams with prescription drug coverage and pharmacy benefit questions. • Respond to inbound calls and inquiries related to Medicare pharmacy benefits, prescription coverage, pharmacy claims, and plan information. • Assist members, providers, brokers, internal teams, and other stakeholders with pharmacy-related questions and issue resolution. • Research and resolve inquiries using internal systems, routing queues, vendor applications, plan documents, and knowledge resources. • Review and interpret pharmacy benefit information, policies, procedures, and plan requirements to provide accurate guidance. • Document all interactions thoroughly and accurately in accordance with compliance and procedural standards. • Escalate complex issues when needed and coordinate with internal teams or vendor contacts to support resolution. • Maintain compliance with HIPAA, Medicare, organizational, and regulatory requirements. • Meet quality, productivity, and customer experience expectations in a structured, monitored environment. • Participate in training and coaching to maintain current knowledge of pharmacy benefits, Medicare programs, and internal processes.