Benefits Analyst
3.
5 Full-time 1 day ago Full Job Description Salary $21.
13 - $33.
81 Hourly $43,954 - $70,326 Annually This position is a Pay Band 65 Purpose of Position Interviews are anticipated to be conducted within two weeks of closing date.
Why does the job exist? Position provides professional and timely customer service, opens and maintains inquiry/complaint files, maintains files in accordance with COBRA and HIPAA Guidelines, Federal Health Care Reform Laws, and the Affordable Care Act, while maintaining a complete archived file system.
This position conducts organizational studies and evaluations, while designing systems and procedures to evaluate work simplification.
Ensures that operations and procedure manuals are evaluated and updated to ensure benefits administrative functions are operating efficiently and effectively.
Provides any necessary reporting requested by immediate supervisor, Deputy Director, and Executive Director.
How does it get done? Initiates the research of claim and eligibility issues and appeals of members by contacting all parties involved to resolve inquiries and complaints.
Identifies any and all issues that are not handled in accordance with the NMPSIA Rules and Regulations, certificates of coverage or benefit summaries and reports all findings.
Maintains member log inquiries, notes and outcomes.
Prepares monthly and yearly claim and resolution reports.
Maintains and manages quality control/satisfaction records, assessing customer service and reporting.
Performs standardized work procedures in accordance with COBRA and HIPAA Guidelines, Federal Health Care Reform Laws, and the Affordable Care Act.
May conduct benefits presentations as needed.
Occasional travel throughout the state to meet and train different schools and entities, which may require overnight stay.
Who are the customers? The position serves over 74,000 total member lives enrolled in NMPSIA's medical, dental, vision, life and long-term disability benefit plans; 88 school districts, 98 charter schools, 26 optional entities, contracted carriers, partnering organizations and the community.
Ideal Candidate Benefits administration experience.
Experienced in assessing and resolving customer service matters.
Delivering information to small and large groups using various modes of technology is preferred.
Preferred flexibility and multi-tasking to meet deadlines.
Preferred ability to work in teams and individually.
Ability to travel when needed for training and Board Meetings.
Minimum Qualification Bachelor's Degree in Business Administration and two (2) years of experience in the procedures of business and management principles involved in strategic planning.
Substitutions Apply.
See Substitution Table below.
Substitution Table These combinations of education and experience qualify you for the position:
Education Experience Education Experience 1 High School Diploma or Equivalent AND 6 years of experience OR High School Diploma or Equivalent AND 6 years of experience 2 Associate's degree in the field(s) specified in the minimum qualification AND 4 years of experience Associate's degree or higher in any field AND 6 years of experience 3 Bachelor's degree in the field(s) specified in the minimum qualification AND 2 years of experience 4 Master's degree or higher in the field(s) specified in the minimum qualification AND 0 years of experience Education and years of experience must be related to the purpose of the position.
If Minimum Qualification requires a specific number of semester hours in a field (e.
g.
6 semester hours in Accounting), applicants MUST have those semester hours in order to meet the minimum qualifications.
No substitutions apply for semester hours.
Employment Requirements Work is usually performed in an office setting with extensive exposure to visual/video display, computer, and phone usage.
Sitting, standing, bending and reaching are part of the work day.
Travel is required.
Extended hours and weekends may be required.
Working Conditions State of New Mexico employees may be impacted by the Public Health Order dated August 12, 2022, which requires facilities licensed or certified by the Centers for Medicare and Medicaid Services (CMS), including all hospital types, long-term care facilities, nursing homes, hospice facilities and rehabilitation facilities, as well as assisted living facilities and adult day care settings, to adhere to all COVID-related requirements prescribed by CMS, including, but not limited to masking and staff vaccination.
In addition, employees working in State correctional facilities who have the potential for direct or indirect exposure to inmates are required to be vaccinated against COVID-19.
Work is performed in an office setting with exposure to Visual/Video Display Terminal (VDT) and extensive personal computer and phone usage.
Possible exposure to irate clientele.
Some statewide travel may be required.
Incumbent will work under stress and frequent time constraints.
Must have own mode of transportation for work-related travel.
Supplemental Information
Benefits:
Do you know what Total Compensation is? Click here Agency Contact Information:
Email For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement.
Bargaining Unit Position This position is not covered by a collective bargaining agreement.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
5 Full-time 1 day ago Full Job Description Salary $21.
13 - $33.
81 Hourly $43,954 - $70,326 Annually This position is a Pay Band 65 Purpose of Position Interviews are anticipated to be conducted within two weeks of closing date.
Why does the job exist? Position provides professional and timely customer service, opens and maintains inquiry/complaint files, maintains files in accordance with COBRA and HIPAA Guidelines, Federal Health Care Reform Laws, and the Affordable Care Act, while maintaining a complete archived file system.
This position conducts organizational studies and evaluations, while designing systems and procedures to evaluate work simplification.
Ensures that operations and procedure manuals are evaluated and updated to ensure benefits administrative functions are operating efficiently and effectively.
Provides any necessary reporting requested by immediate supervisor, Deputy Director, and Executive Director.
How does it get done? Initiates the research of claim and eligibility issues and appeals of members by contacting all parties involved to resolve inquiries and complaints.
Identifies any and all issues that are not handled in accordance with the NMPSIA Rules and Regulations, certificates of coverage or benefit summaries and reports all findings.
Maintains member log inquiries, notes and outcomes.
Prepares monthly and yearly claim and resolution reports.
Maintains and manages quality control/satisfaction records, assessing customer service and reporting.
Performs standardized work procedures in accordance with COBRA and HIPAA Guidelines, Federal Health Care Reform Laws, and the Affordable Care Act.
May conduct benefits presentations as needed.
Occasional travel throughout the state to meet and train different schools and entities, which may require overnight stay.
Who are the customers? The position serves over 74,000 total member lives enrolled in NMPSIA's medical, dental, vision, life and long-term disability benefit plans; 88 school districts, 98 charter schools, 26 optional entities, contracted carriers, partnering organizations and the community.
Ideal Candidate Benefits administration experience.
Experienced in assessing and resolving customer service matters.
Delivering information to small and large groups using various modes of technology is preferred.
Preferred flexibility and multi-tasking to meet deadlines.
Preferred ability to work in teams and individually.
Ability to travel when needed for training and Board Meetings.
Minimum Qualification Bachelor's Degree in Business Administration and two (2) years of experience in the procedures of business and management principles involved in strategic planning.
Substitutions Apply.
See Substitution Table below.
Substitution Table These combinations of education and experience qualify you for the position:
Education Experience Education Experience 1 High School Diploma or Equivalent AND 6 years of experience OR High School Diploma or Equivalent AND 6 years of experience 2 Associate's degree in the field(s) specified in the minimum qualification AND 4 years of experience Associate's degree or higher in any field AND 6 years of experience 3 Bachelor's degree in the field(s) specified in the minimum qualification AND 2 years of experience 4 Master's degree or higher in the field(s) specified in the minimum qualification AND 0 years of experience Education and years of experience must be related to the purpose of the position.
If Minimum Qualification requires a specific number of semester hours in a field (e.
g.
6 semester hours in Accounting), applicants MUST have those semester hours in order to meet the minimum qualifications.
No substitutions apply for semester hours.
Employment Requirements Work is usually performed in an office setting with extensive exposure to visual/video display, computer, and phone usage.
Sitting, standing, bending and reaching are part of the work day.
Travel is required.
Extended hours and weekends may be required.
Working Conditions State of New Mexico employees may be impacted by the Public Health Order dated August 12, 2022, which requires facilities licensed or certified by the Centers for Medicare and Medicaid Services (CMS), including all hospital types, long-term care facilities, nursing homes, hospice facilities and rehabilitation facilities, as well as assisted living facilities and adult day care settings, to adhere to all COVID-related requirements prescribed by CMS, including, but not limited to masking and staff vaccination.
In addition, employees working in State correctional facilities who have the potential for direct or indirect exposure to inmates are required to be vaccinated against COVID-19.
Work is performed in an office setting with exposure to Visual/Video Display Terminal (VDT) and extensive personal computer and phone usage.
Possible exposure to irate clientele.
Some statewide travel may be required.
Incumbent will work under stress and frequent time constraints.
Must have own mode of transportation for work-related travel.
Supplemental Information
Benefits:
Do you know what Total Compensation is? Click here Agency Contact Information:
Email For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement.
Bargaining Unit Position This position is not covered by a collective bargaining agreement.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
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