The Division of Administration/Office of Group Benefitshas a vacancy.
This Position serves as the Group Benefits Analyst in the Customer Services Section of the Office of Group Benefits (OGB) and has the responsibility for providing support functions via call center operations, emails, postal mail and walk-ins. This position provides assistance with the DHH LACHIP program that consists of complex eligibility, premium issues and dependent verification. Other complex programs that may be assigned as Medicare and Medicaid cases which consist of complex and specific federal and state guidelines and timelines, coordination of benefits issues and problems resolutions.
The office of Group Benefits is responsible for managing a statewide employer based comprehensive benefits program for over 230,000 employees, retirees and their
dependents at the State of Louisiana, school boards and other governmental subdivisions. OGB’s Management functions consists of oversight in the administration of benefits provided by third party administrators (TPA’s) while insuring overall program cost, containment and compliance with federal and state mandates. OGB additionally has the responsibility for maintaining insurance plan documents governing the terms and conditions of benefits offered. OGB also monitors administrative cost and recommends containment strategies as well as alternative methods of administering benefits.
AN IDEAL CANIDATE SHOULD POSESS THE FOLLLOWING COMPETENCIES:
- Building and Supporting Teams: The ability to combine one's actions and efforts with others to work toward achieving a common goal.
- Communicating Effectively: The ability to convey information, ideas, and emotions using structured communication methods that promote understanding and engagement.
- Making Accurate Judgments: The ability to assess options, weigh risks, and make sound decisions using available information and logical reasoning.
The Division of Administration is the state government’s management arm and the hub of its financial operations. Division offices perform a wide variety of activities including the following:
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Overseeing the state’s capital construction program
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Working to provide state and federal grants for community development
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Development of the state budget
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Providing technology services
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Giving agencies guidance in the state purchasing and contracting process as they seek goods and services
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Administering a program that provides federal funds to help Louisiana residents recover from a series of devastating hurricanes
Three years of experience in benefits administration, program management, legal research and analysis, health services, claims administration, financial or operational auditing, policy planning or development, contracts or procurement; OR
Six years of full-time work experience in any field; OR
A bachelor's degree.
EXPERIENCE SUBSTITUTION:
Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.
The official job specifications for this role, as defined by the State Civil Service, can be found here.
Job Duties:
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Conduct routine customer service duties and provide assistance to the Customer Service administrator and managers. Take inbound calls in a call center environment to provide assistance and information to plan members, agency representatives, plan providers, third party companies, and the general public and or individual requesting information about the benefits and plans offered to applicable employees, retirees and their dependents. Subject matter typically includes eligibility determination and eligibility status, plan coverage, exclusions and limitations, effective dates, claims history/information, premium rates/collections, payments (refunds, over/under payments) payroll errors, problems, etc. Respond to inquiries and complaints via email, facsimiles, postal mail and/or walk-in clients. Prepare correspondence accordingly and within specific time frames.
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Research and analyze complex situations and complaints for problem resolution and/or provide assistance/information to vendors, plan providers, agency representatives and members. Consult with Call Center Mangers and/or Director as needed. Generate/review reports periodically, may be as often as daily, to aid in research, validation, or verification of information.
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Research and retrieve member records in the imaging system to verify enrollment changes to health and life insurance coverages. Accessing the OGB Impact systems to key demographics, health, and life insurance coverage and verify coverage for active and retired State employees. Prepare documents for imaging.
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Provide assistance to member agencies and benefits providers such as insurance companies, drug providers, pharmacists, etc. to prove clarification and verification of plan members eligibility for services and products and for deceased employee/retirees processes such as update of records, notifications to various entities (Vital Statistics), and coverage adjustments for surviving family members, etc.
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Analyze Medicare data to determine member eligibility and ensure OGB records coordinates with the reports from Centers for Medicare portal.
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All other duties as assigned.
Position-Specific Details:
Appointment Type: This vacancy will be filled by a new hire or by promotion of a current permanent status classified employee. A permanent status employee may be required to serve a new probationary period in lieu of promotion.
Career Progression: This vacancy participates in a career progression group and may be filled from this recruitment as a Group Benefits Analyst 1, 2, or 3, depending on the level of experience of the selected applicant.
Compensation: This position receives a retention pay of $1.00 per hour for each hour worked.
Louisiana is a "State as a Model Employer" for People with Disabilities.
How To Apply:
No Civil Service test score is required in order to be considered for this vacancy.
Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.
- Information to support your eligibility for this job title must be included in the application (i.e., relevant, detailed experience/education). Resumeswill not be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete. The transcripts can be added as an attachment to your online application. The selected candidate will be required to submit original documentation upon hire.
A criminal history check may be conducted on all new hires as well as employees changing positions, including promotions, demotions, details, reassignments, and transfers. Also, prospective employees may be subject to pre-employment drug testing. New hires will be subject to employment eligibility verification via the federal government's E-verify system.
For further information about this posting, please contact:
Erica R. Gay
HR Specialist
Division of Administration/Office of Human Resources
Email:[email protected]
