Competitive Title

Civil Service Examination Required

Salary Range: $93,805.92 - $104,355.68

**THIS IS A PROVISIONAL APPOINTMENT AND IS SUBJECT TO A CIVIL SERVICE EXAMINATION PRIOR TO ANY PERMANENT APPOINTMENT**

DISTINGUISHING FEATURES OF THE CLASS:               The work involves responsibilities for administering and performing specialized employee enrollment processing for health, dental and other benefits. Responsibilities also include explaining and interpreting benefit coverage and claims processing procedures to employees, retirees and their families. Work is performed under the general supervision of the Director of Human Resources and is performed within the guidelines of the various benefit programs. Does related work as required.

TYPICAL WORK ACTIVITIES:

Provides health, dental, retirement and other employee benefit information and explains the various benefits coverage to the employee;

Assures accurate enrollment processing and billing procedures and establishes standards and schedules for such work;

May assist in determining whether claimant is eligible for enrollment and/or payment in accordance with rules and regulations stipulated by benefit programs;

Supervises maintenance of enrollment records and case files on all employees, including forms and documentation of facts;

Answers telephone and written inquiries from parties to claims and advises on status of claim, eligibility criteria, procedures, etc;

Acts as liaison between employees, benefit administrators, doctors, hospitals and other providers regarding benefits programs;

Investigate problem areas and makes recommendations for problem resolution and improved processing; Responds to complaints regarding claims, enrollment, service, etc., when necessary;

Maintains records and prepares required reports.

FULL PERFORMANCE KNOWLEDGE, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS:

Good knowledge of rules, regulations and eligibility criteria of the employee benefits programs; good knowledge of employee benefits terminology and procedures involved in processing benefit claims; good knowledge of business arithmetic and English; ability to follow moderately complex oral and written directions; ability to give information and relate well with people in person and over the phone on benefits and claim matters; good judgment; tact; initiative; courtesy; physical condition commensurate with the demands of the position.

MINIMUM QUALIFICATIONS:

(a)  Graduation from a regionally accredited or New York State registered four-year college or university with a Bachelor’s degree, and three (3) years of experience in verifying and processing insurance claims or in verifying or providing information related to employee benefits;

OR

(b)  Graduation from high school or possession of a high school equivalency diploma and seven (7) years of office experience which included at least three (3) years of experience in verifying and processing insurance claims or in verifying or providing information related to employee benefits;

OR

(c)  An equivalent combination of training and experience as defined by the limits of (a) and (b).

NOTE:     Verifiable part-time and/or volunteer experience will be pro-rated toward meeting full-time experience requirements.