INSURANCE BENEFITS ANALYST 2*-02192026-75347

Job Information

LOCATION OF (1) POSITION(S) TO BE FILLED: DEPARTMENT OF FINANCE AND ADMINISTRATION, STATE INSURANCE GROUP DIVISION, DAVIDSON COUNTY

This position requires a criminal background check. Therefore, you may be required to provide information about your criminal history in order to be considered for this position.

This position is designation as Hybrid (In office and Remote).

Qualifications

Education and Experience: Bachelor's degree and one year of relevant professional experience. Experience in health benefits, life insurance, or call center work may substitute for education up to four years. One year as an Insurance Benefits Analyst may also qualify.

Overview

Under general supervision, the Insurance Benefits Analyst 2 helps manage the State Group Plan benefits by performing a broad range of duties related to insurance benefits administration, including analyzing billing and enrollment data, responding to member inquiries, and ensuring compliance with plan policies. This role is a mid-level position in the analyst series. This class is flexibly staffed with and differs from Insurance Benefits Analyst 1 in that an incumbent of the latter functions in an entry level capacity. This class differs from the Insurance Benefits Analyst 3 in that an incumbent of the latter functions in an advanced working level and/or lead capacity and performs work of greater scope and complexity.

Responsibilities

1. Customer Service answers inbound calls to the Benefits Administration service center providing accurate answers to inquiries and concerns and resolving issues.
2. Communicates benefits and eligibility related information with members, agencies, vendors and providers via phone, chat and email.
3. Compliance maintains compliance with federal and state laws and regulations related to employee benefits.
4. Analyze billing transactions and eligibility records for accuracy and compliance.
5. Interprets the plan document and analyzes submitted insurance enrollments, dependent verification, and special qualifying events for eligibility and accuracy from the original document
6. Assist with the enrollment process and provide support for day-to-day benefits administration operations.
7. Conduct audits, review data for inconsistencies, and update systems accordingly.
8. Coordinate multiple tasks and projects in alignment with priorities and performance standards.

Competencies (KSA's)

Competencies:
1. Customer Focus
2. Manages Complexity
3. Manages Ambiguity
4. Instills Trust
5. Organizational Savvy

Knowledges:
1. Intermediate knowledge of customer service
2. Intermediate knowledge of Microsoft Office
3. Basic knowledge of Mathematics
4. Customer and Personal Service
5. Intermediate knowledge of methods and techniques of research, analysis, and report presentation

Skills:
1. Intermediate writing skills
2. Intermediate speaking skills
3. Intermediate reading comprehension skills
4. Intermediate evaluating and problem-solving skills
5. Intermediate critical thinking skill

Abilities:
1. The ability to navigate multiple systems simultaneously
2. The ability to learn and apply policy/procedure changes
3. Speech Recognition
4. Speech Clarity
5. Deductive reasoning ability

Tools & Equipment

1. Microsoft Office
2. Insurance Databases
3. Mainframe and Internet Applications
4. Standard Office Equipment