Insurance Enrollment & Reconciliation Analyst (104071)

Insurance Enrollment & Reconciliation Analyst

Our mission is simply stated: ERS offers competitive benefits to enhance the lives of its members. Each team member across the agency contributes to our ongoing success. ERS is open for business five days a week, 8:00 am to 5:00 pm, to meet customers where they need us: in person, on the phone, in their communities, and online. ERS currently offers opportunities that include flexible work schedules.

ERS is seeking Insurance Enrollment & Reconciliation Analyst to perform highly complex (senior-level) benefit program assistance and administrative work in Insurance Enrollment & Reconciliation in the Customer Benefits Division. Work involves determining benefits eligibility, processing data related to benefits utilizing a complex system. Has discretion in applying program rules and policies within designated job assignment. Works under limited supervision of the Insurance Enrollment & Reconciliation Supervisor, with moderate latitude to take initiative and exercise independent judgment within policy guidelines to achieve unit goals and objectives.

Essential Responsibilities include, but are not limited to:

• Explains laws, rules, and procedures governing benefits eligibility and enrollment for the Group Benefits Program and the TexFlex Program.
• Verifies eligibility criteria of all participant types.
• Reviews applications for benefits and related legal documents for compliance, accuracy and completeness.
• Processes applications/forms for benefit enrollment and personal information changes and corrections.
• Processes corrections to complex electronic benefit enrollment data using high security access.
• Assists customers with electronic processing of enrollment and change data.
• Updates files and analyzes enrollment and financial records to determine coverage and eligibility of members.
• Analyzes information from reports and outside sources to monitor benefits eligibility.
• Audits benefits enrollment, financial data and vendor reports to identify and correct discrepancies.
• Conducts detailed reconciliation using multiple sources and reports.
• Compiles data and prepares routine or special correspondence as needed.
• Effectively and respectfully communicates with customers, team members, supervisors and other ERS staff.
• Responds to telephone inquiries, email, and written correspondence from customers and internal staff.
• Participates in team discussions regarding benefits, process improvements, and team objectives.
• Prioritizes daily workload to meet departmental goals, and objectives.
• Complies with all applicable agency policies and procedures, including safety and standards of conduct.
• Responsible for working detailed enrollment, reconciliation and discrepancy reports for Medicare eligible members. Responsible for identifying and requesting retiree insurance tiering corrections related to documented years of service
• Reviews applications for benefits and related legal documents for compliance, accuracy and completeness.
• Performs complex Medicare reporting
• Performs system testing

Other Duties and Responsibilities:

• May work with other areas regarding processing issues and or group objectives.
• Assists with special projects within the unit and in other areas within Customer Benefits.
• Performs other duties as assigned.
• Attends work regularly in accordance with agency leave and attendance policies.

Required Minimum Qualifications: Your application for employment must reflect how you meet each of the following minimum qualifications:

1. Graduation from an accredited senior high school or equivalent, plus 60 semester hours of college credit. Qualifying experience beyond the minimum required may substitute for education.
2. Three (3) years' accounting, benefits or payroll experience.
3. One (1) year of experience applying analytical procedures.
4. One (1) year of experience communicating policies and procedures to customers or clients

Preferred Qualifications: Your application for employment should reflect how you meet the following preferred qualifications:

1. Experience with Medicare, examples of duties would be working with enrollment, reconciliation, or responding to customers on Medicare questions.
2. Experience in benefit administration and/or account reconciliation.
3. Experience using a computer to access an integrated information system to retrieve, research and provide information.

Please Note: All submissions should contain complete job history entries, which includes job title, dates of employment, name of employer, and a description of duties performed as related to the position you are applying for. Resumes lacking sufficient detail, such as a summary of experience in lieu of progression of work history may not meet minimum qualifications.

Other Information: In accordance with state law, authorization for telework may not be awarded to an employee as a condition of hiring. As an agency process, new employees complete a 30 day fully onsite period before evaluation for a telework agreement. This position may require access to privileged, confidential, or sensitive data. ERS will conduct either a TXDPS or FBI criminal history check on all new hires. For more information about this policy inquiries can be made to View email address on click.appcast.io. Please note: Internal applicants in the same salary group and classification as the posted position are eligible to receive an increase in salary where applicable up to the posted maximum.

ERS does not sponsor or assume sponsorship of an employment visa at any time.

How to Apply: Interested in joining the ERS team? Apply online through the CAPPS Careers website by completing and submitting the State of Texas Application for Employment.

• Once your profile is complete, click on "View All Jobs" to view available career opportunities and submit your application.

Applications submitted through Work in Texas you will also need to complete a supplemental questions form. For more details, refer to the instructions in the email you receive.

Please contact a Human Resources representative if you need assistance or require accommodation during the application process.

Email: View email address on click.appcast.io

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Relay Texas TDD: View phone number on click.appcast.io