Insurance Benefits Specialist

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. 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. KNOWLEDGE AND ABILITIES: KNOWLEDGE OF: District policies and procedures relating to bargaining unit agreements Applicable laws, codes, rules and regulations including COBRA regulations Various health and life insurance plans, coverage, and exclusions Record-keeping techniques Modern office practices, procedures and equipment Operation of a computer and assigned software Interpersonal skills using tact, patience, and courtesy Correct English usage, grammar, spelling, punctuation, and vocabulary Oral and written communication skills Mathematical computations ABILITY TO: Perform specialized duties related to various employee benefits programs Coordinate the health and welfare program for employees, retirees, and Cobra participants Explain health plan coverage to employees Coordinate open enrollments Respond to requests and inquiries from District employees Interpret, apply and explain applicable laws, codes, rules, and regulations Assemble, organize and prepare data for records and reports Make mathematical computations with speed and accuracy Meet schedules and time lines Maintain records and files and prepare reports Compose correspondence and written materials independently Understand and resolve issues, complaints, or problems Type or input data at an acceptable rate of speed * Communicate effectively both orally and in writing Establish and maintain cooperative and effective working relationships with others Operate a variety of office equipment including a computer and assigned software Maintain confidentiality of sensitive and privileged information Work independently with little direction EDUCATION AND EXPERIENCE: Any combination equivalent to: two years of college-level course work in a related field and three years of experience in a health care, health insurance, or related human resources environment. SELF-CERTIFICATION OF TYPING/KEYBOARDING SKILLS: * This classification requires that incumbents be skilled in typing/keyboarding at a minimum of 45 words per minute. A typing test will not be given. Applicants must certify in writing that they have such skills. Demonstrated proficiency will be expected during the probationary period for the class. WORKING CONDITIONS: ENVIRONMENT: Office environment PHYSICAL DEMANDS: Hearing and speaking to exchange information in person and on the telephone Dexterity of hands and fingers to operate a computer keyboard Seeing to read a variety of materials Sitting for extended periods of time Bending at the waist, kneeling or crouching to file materials This classification description describes the general nature of the work performed, representative duties, as well as the typical qualifications needed for acceptable performance. It is not intended to be a complete list of all responsibilities, duties, work steps, and skills required of the classification.