Class Series Concept
See ES Benefits Technician.
Definition
Supervises Benefits Specialists, coordinates and directs the activities of a unit providing insurance benefits services to claimant/customer and employer.
Distinguishing Characteristics
Working under general direction positions are responsible for the delivery of insurance benefits services. Supervises staff and manages a unit of ES Benefits Specialists.
Typical Work
Provides guidance to staff to ensure the delivery of services and monitors quality, performance and productivity;
Answers highly complex questions and provides advise to claimant/customer and employer on insurance benefits laws, policies and procedures;
Researches and identifies complex issues or facts to respond to claimant/customer and employer inquiries and program complaints;
Supervises a team of ES Benefits Specialists; performs timesheet recording, tracking and approving leave; writes performance expectations and evaluates staff performance, provides regular feedback to staff; interviews and recommends new hires for positions within unit;
Manages program requirements for assigned unit;
Reviews decisions, advises staff and determines if further action is needed;
Provides expert technical assistance, training and guidance to staff regarding the Department’s insurance benefits laws, policies, processes and procedures;
Resolves personnel issues using established processes;
Coordinates with manager and HR staff to resolve escalated personnel issues;
Monitors staff workload, productivity and work product quality;
Leads and coordinates process improvement efforts for internal and agency wide teams;
Performs the duties of the lower levels in the series;
Performs other duties as required.
Answers highly complex questions and provides advise to claimant/customer and employer on insurance benefits laws, policies and procedures;
Researches and identifies complex issues or facts to respond to claimant/customer and employer inquiries and program complaints;
Supervises a team of ES Benefits Specialists; performs timesheet recording, tracking and approving leave; writes performance expectations and evaluates staff performance, provides regular feedback to staff; interviews and recommends new hires for positions within unit;
Manages program requirements for assigned unit;
Reviews decisions, advises staff and determines if further action is needed;
Provides expert technical assistance, training and guidance to staff regarding the Department’s insurance benefits laws, policies, processes and procedures;
Resolves personnel issues using established processes;
Coordinates with manager and HR staff to resolve escalated personnel issues;
Monitors staff workload, productivity and work product quality;
Leads and coordinates process improvement efforts for internal and agency wide teams;
Performs the duties of the lower levels in the series;
Performs other duties as required.
Knowledge and Abilities
Knowledge of: insurance benefits service programs, applicable state and federal laws, regulations and policies, principles, problems, and practices of insurance benefits program administration; principles of individual and group behavior, social behavior, social and economic conditions, and their effects upon individuals; office procedures and practices; supervising subordinate employees.
Ability to: make independent conclusions and decisions; evaluate and recommend changes to insurance benefits program management; work cooperatively with staff, members of the public and with co-workers; practice tact, courtesy and discretion; accurately document, listen, observe, communicate, confront and engage in problem solving and conflict resolution; convey interest and concern to clients requesting information or assistance with problems related to insurance benefits programs and services; express ideas clearly; direct and assist others in interpretation and analysis of data; supervise and train staff.
Ability to: make independent conclusions and decisions; evaluate and recommend changes to insurance benefits program management; work cooperatively with staff, members of the public and with co-workers; practice tact, courtesy and discretion; accurately document, listen, observe, communicate, confront and engage in problem solving and conflict resolution; convey interest and concern to clients requesting information or assistance with problems related to insurance benefits programs and services; express ideas clearly; direct and assist others in interpretation and analysis of data; supervise and train staff.
Legal Requirement(s)
There may be instances where individual positions must have additional licenses or certification. It is the employer’s responsibility to ensure the appropriate licenses/certifications are obtained for each position.
Desirable Qualifications
One year as a ES Benefits Specialist 3.
A Master’s degree in a health or social science, public administration or a related field and two years of experience examining and/or processing loan applications, medical insurance or rehabilitation claims, insurance claims, collection of insurance premiums, tax collection or providing staff support in financial eligibility determination.
A combination of education and relevant experience.
One year of experience equivalent to the ES Benefits Specialist 3 with another state that administers insurance benefits programs.
One year of supervisory experience.
OR
A Bachelor’s degree in a health or social science, public administration or a related field and three years of experience examining and/or processing loan applications, medical insurance or rehabilitation claims, insurance claims, collection of insurance premiums, tax collection or providing staff support in financial eligibility determination.OR
A Master’s degree in a health or social science, public administration or a related field and two years of experience examining and/or processing loan applications, medical insurance or rehabilitation claims, insurance claims, collection of insurance premiums, tax collection or providing staff support in financial eligibility determination.
OR
A combination of education and relevant experience.
OR
One year of experience equivalent to the ES Benefits Specialist 3 with another state that administers insurance benefits programs.
AND
One year of supervisory experience.
Class Specification History
Establishment, adopted June 22, 2023, effective July 1, 2023.