Under the general direction of the Executive Director, serves as a member of the multi-county North Coast Schools’ Medical Insurance Group benefits team. Serves as a key technical and informational contact between Medical, Dental, Vision and Pharmacy carriers, school district personnel, members and providers, including but not limited to, eligibility, billing, and claims. Creates complex technical financial reportsand spreadsheets. Designs strategy for online benefits enrollment management system. Works under the supervision of the Executive Director and supervises the work of the Benefits Clerk.
Examples of Duties
The Benefits Coordinator: conducts, in conjunction with the Executive Director, on-site member trainings, employee open enrollment meetings, and individual member benefits consulting sessions; is the primary system design and technical contact for enrollment management software system; assists the Executive Director in the design and content management of member forms, training materials and website; works in coordination with the Humboldt County Office of Education business office staff to develop tools for member district benefits support; other duties as not specifically described; manages JPA customized database program involving rates, plans, plan descriptions, subscriber information, change updates, and customer problems; coordinates the implementation of plan changes for JPA members; processes enrollment/change forms using custom web-based computer systems; verifies enrollment information and supporting documentation to determine eligibility; updates subscriber information,making necessary changes,and forwards enrollment/change information to vendors adhering to specific timelines; assists subscribers in resolving Medical, Dental, Pharmacy and Vision claim problems that do not require making exceptions to policy; and refers more difficult claim concerns to Executive Director; generates monthly bills and eligibility lists to districts; collects and processes data from districts for monthly financial reports; compiles and prepares monthly financial reports using electronic spreadsheets; provides backup support of support staff and performs other routine office work as necessary.
Education and Experience
Graduation from high school and completion of an AA/AS degree in Business, Accounting or other related field. Education may be waived with at least five years specific employee benefit insurance experience. Advanced skill in Microsoft Excel and other related Microsoft desktop programs. Experience in employee benefits, medical office billing, or insurance company or agency operations required.
- Excellent oral and written English skills including formal business communications, grammar and medical vocabulary. Proficiency in Spanish is desired, but not required.
- Standard CMS-1500 billing form, ICD-9 and CPT coding systems& Code on Dental Procedures and Nomenclature (CDT).
- Construction of insurance contract structure and the ability to read and interpret Summary Benefit Description booklets.
- PC computer operations and various standard, custom and web-based program applications.
- Federal HIPAA privacy laws and Affordable Care Act regulations.
- Establish and maintain positive, collaborative and cooperative working relationships with both internal and external customers, including communicating consistently with tact and courtesy.
- Maintain high ethical standards for all work activity, prioritizing work and multi-tasking to maximize efficiency and productivity of self and others.
- Meet changing deadlines and timelines for work completion.
- Ability to effectively convey technical information to non-technical clients.
- Manage complex data systems and spreadsheets with a high degree of accuracy, including written, numeric and calculated data.
- Read, understand and appropriately apply laws, rules and regulations governing all aspects of insurance operations.
- Adjust to changing work conditions and timelines in a fast-pace, emotionally-charged environment, maintaining absolute confidentiality of work-related information.
- Work independently, with low supervision, using appropriate critical thinking and problem solving skills.
- Ability to sit fixed at a computer for long periods of time.
- Dexterity of hands, fingers and wrists to operate a computer keyboard, adding machine, fax machine and other standard office equipment.
- Ability to read, speak, think and hear in an environment of constant noise and interruption.
- Ability to bend or twist the neck, waist, or knees, while performing activities such as kneeling or crouching while filing or shredding and lifting up to 40 lbs.
Range: 37 | Personnel Commission Approval: February 10, 2015