Disability​/Recoveries Administrative Assistant

PEHP Health & Benefits is a division of the Utah Retirement Systems that proudly serves Utah’s public employees through high quality and competitively priced medical, dental, life, and long-term disability insurance plans on a self-funded basis. As a government entity, we embrace both a public mission and a commitment to creating customer value, excelling in the market, and improving healthcare. We offer a competitive salary with generous benefits, personal development in a positive team environment, and excellent work-life balance.

For most jobs, remote work is available for 9 out of every 10 workdays.

POSITION SUMMARY

This position plays a critical role in PEHP’s efforts to serve and create value for our members by helping them understand their benefits, resolve problems, and assisting with requests for benefit eligibility. Performs a variety of administrative duties and data entry for compiling disability claim files, obtaining medical records, and tracking premium payments. Responsible for various administrative tasks, data entry, and reviews related to third party liability and over payment recovery.

This position requires strong organizational skills and the ability to manage diverse tasks in a supportive role.

Successful performance for this position requires a genuine interest in helping others, a high level of commitment, attention to detail, and the ability to learn about and share complex information.

ESSENTIAL DUTIES & RESPONSIBILITIES

• Monitors, documents, and quality checks premium payments from participating employers. Contacts employers regarding delinquent payments/errors and sends demand letters. Assists with monthly audit process of premium payments.
• Maintains and calculates annual review of COLA increases for beneficiaries and mails notifications.
• Processes mail, data entry, receives phone inquiries, answers general questions, maintains claim diaries of tasks, provides administrative and clerical support and prepares routine and specialized correspondence.
• Assists Disability Specialists with monthly payroll audit, claims updates, and annual W-2 process.
• Maintains pending disability applications to include creating electronic files, notifies and obtains information from employers and URS, requests medical records, and pays record invoice.
• Maintains electronic files in Laserfiche and quality checks imaging process.
• Prepares files and documentation for medical consultant reviews, vocational reviews, and clinical visits.
• Compiles data spreadsheets for pending claims and file reviews.
• Compiles data spreadsheets for outside collection vendor for placement of member and provider over payments.
• Runs departmental monthly reports and completes required tasks.
• Reviews existing refund requests for medical/dental claims for receipt.
• Processes refund requests for medical/dental over payments.
• Processes deductions for PEHP medical and dental.
• Places holds on member claims related to third party liability, creates documentation and correspondence and performs follow-up tasks through phone calls, email and/or letters.
• Performs other related duties as required.
• Maintains regular and reliable attendance.
• Maintains strict confidentiality.

Education and Experience

High School diploma and two (2) years of experience performing a variety of clerical, technical, and administrative duties; or an equivalent combination of education and experience.

Specific experience in LTD/time-loss insurance claims, advanced knowledge of personal computer operations, and medical/dental terminology is preferred.

Knowledge, Skills, and Abilities

This list contains knowledge, skills, and abilities that are typically associated with the job. It is not all-inclusive and may vary from…