Employee Benefits Specialist

Description

Examples of Duties

• Provides verbal and written information to employees regarding the various employee health insurance plans and applicable procedures.
• Responds to inquiries regarding payment of claims and clarifies plan benefits.
• Assists individual employees with insurance problems, such as claims allegedly not paid according to provision of plan; requests that insurance providers re-evaluate payment of claims as needed; and informs employees if expenses are covered or not covered.
• Processes various forms and documents between employees and insurance providers such as applications for coverage, addition of new dependents, new enrollments under dependent coverage, change in coverage, and terminations.
• Performs additions and deletions of enrollment through direct interface with various carriers’ portals.
• Audits carriers’ records for errors and inconsistencies; directs corrections.
• Provides COBRA/conversion information regarding rates and plans to enroll dependents of deceased employees, retirees, and former employees; prepares and forwards forms in compliance with COBRA laws and contract parameters.
• Reconciles records of the City with those of the insurance providers; coordinates corrections.
• Processes and maintains retiree payments for continuation of health and life insurance coverage; sends past due letters, and makes arrangements to collect payment of NSF checks.
• Reviews and reconciles monthly bills for health, dental, disability, long-term care, vision, supplemental, and life insurance plans for payment.
• Assists with the development of new benefits programs and modifications to existing benefit programs.
• Conducts new employee orientation and annual open enrollment for health benefits.
• Performs related work as required.

Requirements

• Graduation from an accredited college or university with Bachelor’s Degree in Risk & Insurance Management, Health Administrative/Health Services, Human Resources, Public or Business Administration or a closely related field. Master’s Degree preferred

• Reasonable experience in employee group health, dental, life, disability insurance programs, plan administration and implementation and COBRA regulations;
• Knowledge of self-insurance benefits administration.
• Knowledge of all benefit related laws and regulations including, but not limited to, Affordable Care Act, Health Insurance Portability and Accessibility Act (HIPAA), Consolidated Omnibus Budget Reconciliation Act (COBRA), federal and state laws, and other applicable regulations.
• Experience in a self-insured, governmental and union environment preferred
• Experience utilizing Tyler-Munis ERP preferred
• Certified Employee Benefit Specialist (CEBS) preferred
• Registered Employee Benefits Consultant (REBC) preferred

• Possession a valid driver's license with an acceptable driving record
• Must obtain a valid Florida license within thirty (30) days of residency or accepting employment

Supplemental Information

• Knowledge of employee group health, dental, life, vision, long-term care, disability insurance programs, plan administration and implementation, COBRA regulations and state and federal compliance requirements.
• Knowledge of self-insurance benefits administration.
• Knowledge of the policies and procedures of insurance organizations providing group health and life insurance coverage.
• Knowledge of department rules, regulations, and procedures pertaining to insurance activities.
• Knowledge of general office procedures, practices, and equipment.
• Skill in the use of personal computer.
• Ability to assemble information from office records and to prepare accurate and complete reports.
• Ability to establish and maintain effective working relationships with various levels of City employees and representatives of insurance organizations.
• Ability to understand and interpret the provisions of various group health insurance plans applicable to the City.
• Ability to express ideals clearly and concisely, both verbally and in writing.
• Ability to exercise judgment and discretion in the application of department policies and procedures to group health insurance problems and circumstances.
• Ability to deal tactfully and effectively with a variety of employees and officials in both the public and private sectors.