Insurance Administrator

Job Summary

This position is responsible for providing PERA’s insurance program information to retired and active members. Ability to comprehend and communicate insurance plan details, respond effectively to inquiries, and resolve elevated issues. Advocates with carriers on behalf of members and understands compliance issues with insurance plans.

IDEAL CANDIDATE

The ideal candidate is a detail-oriented and customer-focused professional who excels at clearly communicating complex insurance information to diverse audiences. They bring strong analytical and problem-solving skills, are comfortable managing multiple priorities and interruptions, and have experience resolving eligibility, coverage, and claims issues. This individual is proactive, organized, and collaborative, serving as an effective liaison between members and insurance carriers while maintaining compliance, accuracy, and a high standard of customer service.

Essential Functions

Employees are held accountable for all duties of the job. Individuals must be able to perform these duties with or without reasonable accommodations.

• Provides accurate and timely health care, prescription drug, dental, vision, and life insurance information to PERA’s retired and active members
• Engages in daily communications with members to effectively explain and clarify plan information via in-person, phone, and written correspondence.
• Performs day-to-day administration of PERA's insurance programs and services. Handles basic and routine tasks under the direction of the Insurance Manager and/or the Senior Insurance Administrator.
• Acts as liaison between members and carriers in researching and resolving eligibility, coverage, and claims issues
• Manages and completes workflow items and reports, such as discrepancy reports and aging out of the plan
• Provides excellent customer service
• Manages multiple interruptions on a daily basis
• Utilizes analytical reasoning skills and proactive research methods to assist with and prepare for member interactions
• Processes and resolves members’ inquiries and issues, such as claims and prescription drug eligibility
• Reconciles premium payments and eligibility of enrollees with carriers
• Prioritizes and organizes work, maximizing effectiveness to efficiently meet deadlines
• Maintains regular and prompt attendance in the workplace
• Carries out other duties as assigned
  
  

Qualifications

• Bachelor's degree in a business-related field or equivalent combination of education and experience.
• 1 to 2 years’ experience in insurance or employee benefits.
• Possesses working knowledge of health, dental, vision, prescription, and life insurance
• Must be able to provide an excellent customer service experience and to assist a retired population
• Analytical, detail-oriented with an aptitude for math
• Proficiency with Microsoft Office
• Ability to ask clarifying questions to effectively resolve member or retiree issues
• Ability to comprehend and communicate insurance plan details
• Ability to deal with sensitive and/or confidential information and situations
• Ability to prioritize, organize, and work with minimal supervision
• Effective verbal and written interpersonal communication skills
• Ability to travel overnight on a limited basis
  
  

WORKING CONDITIONS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• Standard office environment with frequent telephone communication, computer operation, and other office productivity machinery, such as a copy and printer machine.
• Occasional moving and positioning supplies in excess of 20 pounds
• All employees are expected to present themselves in a professional manner in alignment with the financial services industry
• Ability to sit for prolonged periods of time
• Ability to operate standard PC equipment
• Ability to manage frequent deadlines and tight schedules
  
  

HYBRID WORK OPTION

• Opportunity to work from home up to two days per week. Eligibility dependent upon factors detailed in PERA's Work from Home Policy.