Compensation & Benefits Specialist; Provisional; Comp

An incumbent to a position in this class administers multiple benefits programs, including Workers’ Compensation and Injured-On-Duty (for Police and Fire), for city employees/retirees as assigned. S/he interprets the provisions of labor contracts in relation to employee’s fringe benefits and other terms and conditions of employment. The incumbent is in frequent oral and written communication with employees, management and vendors clarifying benefits and worker’s compensation/IOD claims.

Incumbents maintain complex spreadsheets and databases for information using various computer software packages. Immediate supervision is received from the Director of Compensation and Benefits or a designee. No supervisory duties are exercised.

• Works with the City of Buffalo’s third party administrator and fee scheduler and vendors for worker’s compensation and IOD claims;
• Analyzes compensation claims to determine eligibility for benefits;
• Investigates claims with the outside vendor and/or department supervisors, and ensures that interviews with claimants and witnesses are complete;
• Interacts with contracted claims adjustment service in all compensation related matters;
• Reviews and maintains reports from claims adjustment service to insure adequacy of service;
• Reviews worker’s compensation and IOD fee scheduled statements received from third party administrator or fee scheduler for accuracy;
• Consults with outside medical personnel and the respective police or fire department to obtain all required progress notes, diagnosis and claim information;
• Reviews for accuracy and processes worker’s compensation payroll data and submits to Division of Audit;
• Assures payment checks are sent to injured employees;
• Coordinates claims processing and payroll information with other departments;
• Coordinates with worker’s compensation third party administrators and department heads for return to work and light duty assignments;
• Performs related duties as required.

• Advises new and current employees of employment benefits;
• Determines and advises on benefits eligibility date;
• Conducts benefit orientations;
• Reviews and processes all enrollment applications;
• Ensures receipt of proper backup documentation for proof of spousal and dependent eligibility;
• Counsels employees, dependents and beneficiaries on insurance plans and other benefits;
• Maintains employee records regarding health insurance selection, type of policy, eligibility, termination date, etc.;
• Initiates and processes changes as required;
• Reports residence anomalies to the Civil Service Division for residency investigation;
• Advises Director of Compensation and Benefits and/or Human Resources Commissioner of unauthorized dependents listed or remaining on insurance plans;
• Gathers all submitted documents and presents same for decision;
• Precludes unauthorized individuals to enroll for benefits;
• Assists with open enrollment as scheduled;
• Conducts meetings for employees and spouses/dependents;
• Assists with processing questions;
• Enters benefit information for each employee into Munis including all dependent information;
• Records and reports divorces and other changes of status immediately to the insurance carrier to ensure accurate payment for eligible dependents;
• Verifies Munis rate tables are accurate based upon union, seniority, etc.;
• Provides for employee group insurance claims assistance and referral;
• Advises employees of reinstatements or termination date of benefits;
• Sends appropriate compliance forms and documentation such as COBRA, FMLA, etc. in a timely manner;
• Counsels employees prior to retirement to determine eligibility for benefits from the New York State Retirement System, Social Security, etc.;
• Assists potential retirees with purchasing and receiving credit for prior service time;
• Maintains updated list of retirees and processes changes in medical insurance coverage due to death, marriage, or Medicare eligibility;
• Monitors the Social Security Index spreadsheet ensuring all deceased employees are removed from all insurances and that spouses and dependents are appropriately notified of COBRA rights;
• Applies all new contracts and legal decisions,…