Insurance Benefits Analyst 2

Job Information

State of Tennessee Job Information

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

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

Competencies (KSA's)

Competencies

• Customer Focus
• Manages Complexity
• Manages Ambiguity
• Instills Trust
• Organizational Savvy

Knowledges

• Intermediate knowledge of customer service
• Intermediate knowledge of Microsoft Office
• Basic knowledge of Mathematics
• Customer and Personal Service
• Intermediate knowledge of methods and techniques of research, analysis, and report presentation

Skills

• Intermediate writing skills
• Intermediate speaking skills
• Intermediate reading comprehension skills
• Intermediate evaluating and problem-solving skills
• Intermediate critical thinking skill

Abilities

• The ability to navigate multiple systems simultaneously
• The ability to learn and apply policy/procedure changes
• Speech Recognition
• Speech Clarity
• Deductive reasoning ability

Tools & Equipment

• Microsoft Office
• Insurance Databases
• Mainframe and Internet Applications
• Standard Office Equipment