Purpose and Scope
The Benefits Specialist is responsible for processing and providing guidance on a wide variety of insurance related issues including health, dental, vision, prescription drug, life, disability, leave of absence and COBRA. Reviews and makes recommendations for HRIS, payroll and vendor databases to ensure accurate insurance option elections, payroll deductions and vendor payments.
Essential Job Functions
Works with active employees, retirees, spouses, dependents, and beneficiaries on all Memphis-Shelby County School (MSCS) insurance plans and various kinds of leave. Explains eligibility requirements, enrollment, deadlines, application process, and various plan options.
Evaluates and determines the eligibility of employees, retires, spouses, domestic partners, dependents and beneficiaries for insurance elections, deductions or payouts in compliance with multiple insurance summary plan description document rules and insurance vendor enrollment policies and procedures as well as open enrollment and special enrollment period regulations.
Tracks, processes and provides guidance on all insurance related topics such as health, dental, vision, prescription drug and COBRA, basic and supplemental life and voluntary long term disability plans to identify the employee’s options for concerns and/or issues.
Tracks, processes, and provides guidance on all insurance payments related options such as Flexible Spending Accounts (FSA) for healthcare and dependent care reimbursements, Health Reimbursement Accounts (HRA), premium assistance programs and options under the Affordable Care Act (ACA).
Tracks, processes and provides detailed information to staff and retirees on all the different insurance plan estimates for medical payments to identify the employee’s options for concerns and/or issues.
Works with spouses, domestic partners, dependents, and beneficiaries to file the appropriate forms for a death claim with the life insurance vendors.
Processes all insurance related Court Order requirements such as Qualified Medical Child Support Orders (QMCSO).
Prepares, reviews and revises insurance option elections, premium deductions and insurance payouts in HRIS and payroll and verifies the information is correct in the vendor databases for timeliness, accuracy and vendor payments.
Informs payroll of insurance related issues such as new enrollments, election changes, Qualifying Life Events (QLE) adjustments, terminations, COBRA and Court Order requirements affecting insurance.
Prepares and maintains standard reports, records, correspondence, and files related to assigned employee population for insurance. Maintains confidentiality up to HIPPA standards.
Process Tennessee Consolidated Retirement System refunds, 403(b) Annuity and Empower requests as well as process any required adjustments, payments, refunds needed through the payroll system.
Performs other related duties as assigned or directed.
Minimum Qualifications
Bachelor’s Degree in closely related field plus a minimum of one (1) year of insurance experience to include medical, dental, vision, life or COBRA insurance or any equivalent combination of education, training, insurance, or human resources experience which provides the requisite knowledge, skills and abilities for this position for a total of five (5) years. (PROOF OF EDUCATION, TRAINING, AND/OR EXPERIENCE IS REQUIRED)
Degree Equivalency Formula:Bachelor’s Degree= 4 years plus required years of experience.Master’s Degree=6 years plus required years of experience.
Additional Job Details
HIPAA REQUIREMENT All employees who have access to health information which requires confidentiality procreated by the HIPAA Privacy Rule are required by the Rule to receive training so that they have an understanding and knowledge of both the Privacy Rule that corresponds to their job responsibilities and of the health plan's policies and procedures that impact on their job duties. Training on the requirements of the HIPAA Privacy Rule and the plan's health information policies and procedures under the direction of the plan Privacy Officer must be completed within the initial six (6) months as a condition of continued employment. Employees who violate the requirements of the HIPAA Privacy Rule will be subject to disciplining action up to and including termination.
