Insurance Enrollment & Reconciliation Analyst

Insurance Enrollment & Reconciliation Analyst

Our mission is simply stated: ERS offers competitive benefits to enhance the lives of its members. Each team member across the agency contributes to our ongoing success. ERS is open for business five days a week, 8:00 am to 5:00 pm, to meet customers where they need us: in person, on the phone, in their communities, and online. ERS currently offers opportunities that include flexible work schedules.

ERS is seeking Insurance Enrollment & Reconciliation Analyst to perform highly complex (senior-level) benefit program assistance and administrative work in Insurance Enrollment & Reconciliation in the Customer Benefits Division. Work involves determining benefits eligibility, processing data related to benefits utilizing a complex system. Has discretion in applying program rules and policies within designated job assignment. Works under limited supervision of the Insurance Enrollment & Reconciliation Supervisor, with moderate latitude to take initiative and exercise independent judgment within policy guidelines to achieve unit goals and objectives.

Essential Responsibilities include, but are not limited to:

• Explains laws, rules, and procedures governing benefits eligibility and enrollment for the Group Benefits Program and the Tex Flex Program.
• Verifies eligibility criteria of all participant types.
• Reviews applications for benefits and related legal documents for compliance, accuracy and completeness.
• Processes applications/forms for benefit enrollment and personal information changes and corrections.
• Processes corrections to complex electronic benefit enrollment data using high security access.
• Assists customers with electronic processing of enrollment and change data.
• Updates files and analyzes enrollment and financial records to determine coverage and eligibility of members.
• Analyzes information from reports and outside sources to monitor benefits eligibility.
• Audits benefits enrollment, financial data and vendor reports to identify and correct discrepancies.
• Conducts detailed reconciliation using multiple sources and reports.
• Compiles data and prepares routine or special correspondence as needed.
• Effectively and respectfully communicates with customers, team members, supervisors and other ERS staff.
• Responds to telephone inquiries, email, and written correspondence from customers and internal staff.
• Participates in team discussions regarding benefits, process improvements, and team objectives.
• Prioritizes daily workload to meet departmental goals, and objectives.
• Complies with all applicable agency policies and procedures, including safety and standards of conduct.
• Responsible for working detailed enrollment, reconciliation and discrepancy reports for Medicare eligible members. Responsible for identifying and requesting retiree insurance tiering corrections related to documented years of service
• Reviews applications for benefits and related legal documents for compliance, accuracy and completeness.
• Performs complex Medicare reporting
• Performs system testing

Other

Duties and Responsibilities:

• May work with other areas regarding processing issues and or group objectives.
• Assists with special projects within the unit and in other areas within Customer Benefits.
• Performs other duties as assigned.
• Attends work regularly in accordance with agency leave and attendance policies.

Required

Minimum Qualifications:

Your application for employment must reflect how you meet each of the following minimum qualifications:

Preferred Qualifications:

Your application for employment should reflect how you meet the following preferred qualifications:

Please Note:

All submissions should contain complete job history entries, which includes job title, dates of employment, name of employer, and a description of duties performed as related to the position you are applying for. Resumes lacking sufficient detail, such as a summary of experience in lieu of progression of work history may not meet minimum qualifications.

Other Information:
In accordance with state law, authorization for telework may not be awarded to an employee as a condition of hiring. As an agency process, new employees complete a 30 day fully onsite period before evaluation for a telework agreement. This position may require access to privileged,…