GROUP BENEFITS ANALYST 1, 2, OR 3

The Division of Administration/Office of Group Benefits has a vacancy.

The Agency Services Division analyzes and reviews benefits data, supports research for appeals, subrogation, and other legal matters, and develops training, policies, and procedures to ensure accurate management of benefits information in compliance with Office of Group Benefits (OGB), provider, and federal and state requirements.

OGB administers a comprehensive, employer-based benefits program serving approximately 230,000 participants across the State of Louisiana, school boards, and other governmental entities. This includes oversight of third-party administrators, ensuring cost containment, maintaining plan documents, and ensuring compliance with applicable laws and regulations, including ERISA, COBRA, ACA, HIPAA, and IRS requirements related to benefits programs.

This position provides front-line and advanced support for OGB agency services by processing benefits documentation, resolving complex eligibility and coverage issues, and assisting agencies and members through Help Desk operations. The role also supports compliance and program integrity through research, appeals and legal support, and coordination of collections, terminations, and enrollment activities.

AN IDEAL CANIDATE SHOULD POSESS THE FOLLLOWING COMPETENCIES:
•Building and Supporting Teams: The ability to combine one's actions and efforts with others to work toward achieving a common goal.
•Communicating Effectively: The ability to convey information, ideas, and emotions using structured communication methods that promote understanding and engagement.
•Making Accurate Judgments: The ability to assess options, weigh risks, and make sound decisions using available information and logical reasoning.

The Division of Administration is the state government’s management arm and the hub of its financial operations. Division offices perform a wide variety of activities including the following:

• Overseeing the state’s capital construction program
• Working to provide state and federal grants for community development
• Development of the state budget
• Providing technology services
• Giving agencies guidance in the state purchasing and contracting process as they seek goods and services
• Administering a program that provides federal funds to help Louisiana residents recover from a series of devastating hurricanes

Three years of experience in benefits administration, program management, legal research and analysis, health services, claims administration, financial or operational auditing, policy planning or development, contracts or procurement; OR

Six years of full-time work experience in any field; OR

A bachelor's degree.


EXPERIENCE SUBSTITUTION:
Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.The official job specifications for this role, as defined by the State Civil Service, can be found here.Job Duties:
Document Processing
Conducts routine agency service duties, such as processing the multitude of documents submitted by agencies and provide assistance to the Agency Services managers. Takes inbound calls as needed for the HR HelpDesk to provide assistance and information to agency representatives. Subject matter includes eligibility determination and eligibility status, plan coverage, exclusions and limitations, effective dates, claims history/information, premium rates/collections, payments (refunds, over/under payments) payroll errors, problems, etc. Respond to inquiries and complaints. Research and analyze complex situations and complaints for problem resolution and/or provide assistance/information to agency representatives and members. Research and retrieve member records in the imaging system to verify enrollment changes to health and life insurance coverages. Accessing the OGB Impact systems to key demographics, health, and life insurance coverage and verify coverage for active and retired State employees.

Man the eEnrollment HelpDesk Line
Take inbound and make outbound calls from agencies; respond to tickets from agencies; provide guidance and support to all agencies covered under OGB. This requires an advanced level of knowledge on agencies, eligibility rules, regulations, and laws, and an in depth knowledge of the Impact system and its requirements. Remain aware of current legislation that relates to OGB as the rules and regulations could change annually. Requires up to date knowledge on all new eligibility requirements related to new legislation, and being prepared to speak to agencies in relation to such. Conferring with agencies on a multitude of situations in order to get members placed into the Impact system properly so members do not face delays in insurance coverage. Calls are typically about topics that are more complex and detailed, and require advanced level of customer service skills and OGB eligibility, rules and laws. Handle appropriately all calls that are being escalated to a higher level of supervision by subordinate staff, like irate customers.

Participation Requests
Processes participation requests; makes decisions when additional research is needed. Coordinates with managers on pulling records from the imaging system and OGB microfiche. Assists in research as needed when using Office of State Uniform Payroll (OSUP) microfiche.

Appeals/Legal Research
Gathers data for requests from plan participants and/or Office of General Counsel (OGC) about for claims, appeals, law suits and public records requests. Retrieves records from imaging system, IMPACT, and Customer Service phone calls relevant to individual requests. Confers with director monthly to discuss outstanding issues or need for action by OGB. Attends trainings led by OGC and other OGB departments.

Collections/Terminations
Processing of termination documents. Creates list of retroactive terminations to be researched for potential collections, both for pharmacy and medical. Runs claims reports on potential amounts due to OGB. Updates manager weekly on accounts to be reprocessed. Reviews claims reports for members to determine how much is collectable. Creates reports for Office of Debt Recovery and confers with manager on current and prescribed debt. Researches eligibility issues for verification of determining amounts due. Creates and tracks demand letters to be issued. Takes collections phone calls and converses with plan members in regards to amounts due.

Other
All other duties as assigned.

Position-Specific Details:
Appointment Type:This vacancy will be filled by a new hire or by promotion of a current permanent status classified employee. A permanent status employee may be required to serve a new probationary period in lieu of promotion.

Louisiana is a "State as a Model Employer" for People with Disabilities.

Career Progression:This vacancy participates in a career progression group and may be filled from this recruitment as a Group Benefits Analyst 1, 2, or 3, depending on the level of experience of the selected applicant.

Compensation:This position receives a retention pay of $1.00 per hour for each hour worked.

How To Apply:

No Civil Service test scoreis required in order to be considered for this vacancy.

To apply for this vacancy, click on the “Apply” link above and complete an electronic application, which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.

*Information to support your eligibility for this job title must be included in the application (i.e., relevant, detailed experience/education).Resumeswill notbe accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.

A criminal history check may be conducted on all new hires as well as employees changing positions, including promotions, demotions, details, reassignments, and transfers.Also, prospective employees may be subject to pre-employment drug testing. New hires will be subject to employment eligibility verification via the federal government's E-verify system.

Applicants qualifying based on college training or receipt of a baccalaureate degree will be required to submit an official college transcript to verify credentials claimed prior to appointment. Please make every effort to attach a copy of your transcript to your application. The transcripts can be added as an attachment to your online application. The selected candidate will be required to submit original documentation upon hire.

For further information about this posting, please contact:
Erica R. Gay
HR Specialist
Division of Administration/Office of Human Resources
email: Erica.Gay@la.gov