Insurance Benefits Specialist

JOB
The current vacancy is 8 hours per day, 12 months per year, located within our Human Resources Office at the District Office. The eligibility list will be used for hiring purposes and will be active for six (6) months (Merit Rule 50.100.1).Selection ProcedureApplications will be screened, and those candidates whose backgrounds best match the requirements of the position will be invited to participate in a competitive examination process, which may include any combination of the following: Training & Experience evaluation (T&E), multiple-choice question test, job-related performance exercise, and technical/ oral appraisal interview. Examination procedures are subject to change as deemed necessary by the Director of the Personnel Commission.Candidates who pass all of the examination processes are ranked on an eligibility list according to their score(s). Selection for the position will be made from among the top three (3) ranks of candidates. BASIC FUNCTION: Under the direction of the Assistant Superintendent or Director of Personnel Support Services, perform a variety of specialized duties in support of the District’s insurance benefits programs and services; provide information to District employees regarding health and welfare benefits; coordinate open enrollments and enroll employees; serve as a liaison between insurance companies and employees. DISTINGUISHING CHARACTERISTICS: The Insurance Benefits Specialist provides work direction to the Insurance Benefits Technician and performs a wide range of complex and highly technical and analytical duties as they relate to benefit programs. Additionally, the Insurance Benefits Specialist provides input to the negotiation process with bargaining units. The Insurance Benefits Technician independently performs duties to support the insurance benefits programs, providing information and guidance to employees and retirees through every phase of the benefit process. The Insurance Benefits Assistant is the entry level of the series, receiving training to learn rules, laws, policies and procedures associated with the group employee benefit programs.

EXAMPLE OF DUTIES
REPRESENTATIVE DUTIES: Perform a variety of specialized duties in support of the District’s insurance benefits programs and related services; assure compliance with applicable laws, codes, rules, and regulations. Meet with individual and groups of new hires and employees to discuss and clarify District health and welfare benefits; enroll employees and dependents into District health plans; enter coverage codes into computer; mail enrollment forms to carriers and mail verification letters and benefit summaries to employees. Provide information and assistance to employees in the process of changing existing health benefits as employees experience a change in dependent eligibility; make appropriate changes in codes; mail changes to the carries and verification letters and reports to employees. Serve as a liaison between employees and insurance company representatives and agents; remain current on vendor and legislature policy changes; organize and maintain information, procedures and forms regarding insurance benefit programs provided by the District for employees; distribute insurance brochures to employees. Coordinate District-wide open enrollments; compose related communications; organize publication and distribution of insurance packets; attend insurance meetings; forward enrollment forms to insurance carriers; provide code/premium updates and forward verification letters to employees. Communicate with District employees and outside agencies to provide clarification regarding benefit claim submission information, contract language, and denied/pending claims; assist employees in the resolution of claim payment and coverage discrepancies. Provide COBRA letters to eligible employees or dependents experiencing a loss of benefits; provide monthly payment coupons to individuals extending coverage; serve as a liaison between the District and the insurance consultant. Prepare monthly billing audits for services and carriers including medical, life, vision, and dental agencies; issue payment requests to the accounting department based on audits and in accordance with established timelines. Process life insurance claims; assure proper paperwork is completed; mail appropriate forms. Prepare correspondence to retirees and employees on a leave of absence; provide annual, semi-annual, or quarterly billings as required; calculate premiums and post payments. Monitor flexible spending accounts including Medical and Dependent Care reimbursements; audit and balance accounts; verify and resolve discrepancies; receive checks; prepare and submit deposits. Establish and maintain a variety of records, files and reports related to insurance benefit information and employees; cost out benefit projections as requested; provide budget estimates as requested. Operate a variety of office equipment including a computer and assigned software. Attend a variety of meetings, conferences, and workshops as assigned.Perform related duties as assigned as they relate to the classification.

SUPPLEMENTAL INFORMATION
KNOWLEDGE AND ABILITIES: KNOWLEDGE OF: District policies and procedures relating to bargaining unit agreementsApplicable laws, codes, rules and regulations including COBRA regulationsVarious health and life insurance plans, coverage, and exclusionsRecord-keeping techniquesModern office practices, procedures and equipmentOperation of a computer and assigned softwareInterpersonal skills using tact, patience, and courtesyCorrect English usage, grammar, spelling, punctuation, and vocabularyOral and written communication skillsMathematical computationsABILITY TO: Perform specialized duties related to various employee benefits programsCoordinate the health and welfare program for employees, retirees, and Cobra participantsExplain health plan coverage to employeesCoordinate open enrollmentsRespond to requests and inquiries from District employeesInterpret, apply and explain applicable laws, codes, rules, and regulationsAssemble, organize and prepare data for records and reportsMake mathematical computations with speed and accuracyMeet schedules and time linesMaintain records and files and prepare reportsCompose correspondence and written materials independentlyUnderstand and resolve issues, complaints, or problemsType or input data at an acceptable rate of speed *Communicate effectively both orally and in writingEstablish and maintain cooperative and effective working relationships with othersOperate a variety of office equipment including a computer and assigned softwareMaintain confidentiality of sensitive and privileged informationWork independently with little directionWORKING CONDITIONS: ENVIRONMENT: Office environment. PHYSICAL DEMANDS: Dexterity of hands and fingers to operate a computer keyboard.Hearing and speaking to exchange information in person and on the telephone.Seeing to read a variety of materials.Sitting for extended periods of time.Bending at the waist, kneeling or crouching to file materials.The Poway Unified School District (PUSD) is an equal opportunity employer/program and is committed to an active Nondiscrimination Program. PUSD prohibits discrimination, harassment, intimidation, and bullying based on actual or perceived ancestry, age, color, disability, gender, gender identity, gender expression, nationality, race or ethnicity, religion, sex, sexual orientation, or association with a person or a group with one or more of these actual or perceived characteristics. For more information, please contact the Title IX/Equity Compliance Officer, Associate Superintendent of Personnel Support Services, Poway Unified School District, 15250 Avenue of Science, San Diego, CA 92128-3406, 858-521-2800.