See ES Benefits Technician.

Supervises Benefits Specialists, coordinates and directs the activities of a unit providing insurance benefits services to claimant/customer and employer.

Working under general direction positions are responsible for the delivery of insurance benefits services. Supervises staff and manages a unit of ES Benefits Specialists.

Provides guidance to staff to ensure the delivery of services and monitors quality, performance and productivity;

Answers highly complex questions and provides advise to claimant/customer and employer on insurance benefits laws, policies and procedures;

Researches and identifies complex issues or facts to respond to claimant/customer and employer inquiries and program complaints;

Supervises a team of ES Benefits Specialists; performs timesheet recording, tracking and approving leave; writes performance expectations and evaluates staff performance, provides regular feedback to staff; interviews and recommends new hires for positions within unit;

Manages program requirements for assigned unit;

Reviews decisions, advises staff and determines if further action is needed;

Provides expert technical assistance, training and guidance to staff regarding the Department’s insurance benefits laws, policies, processes and procedures;

Resolves personnel issues using established processes;

Coordinates with manager and HR staff to resolve escalated personnel issues;

Monitors staff workload, productivity and work product quality;

Leads and coordinates process improvement efforts for internal and agency wide teams;

Performs the duties of the lower levels in the series;

Performs other duties as required.

Knowledge of: insurance benefits service programs, applicable state and federal laws, regulations and policies, principles, problems, and practices of insurance benefits program administration; principles of individual and group behavior, social behavior, social and economic conditions, and their effects upon individuals; office procedures and practices; supervising subordinate employees.

Ability to: make independent conclusions and decisions; evaluate and recommend changes to insurance benefits program management; work cooperatively with staff, members of the public and with co-workers; practice tact, courtesy and discretion; accurately document, listen, observe, communicate, confront and engage in problem solving and conflict resolution; convey interest and concern to clients requesting information or assistance with problems related to insurance benefits programs and services; express ideas clearly; direct and assist others in interpretation and analysis of data; supervise and train staff.

There may be instances where individual positions must have additional licenses or certification. It is the employer’s responsibility to ensure the appropriate licenses/certifications are obtained for each position.

One year as a ES Benefits Specialist 3.

OR

A Bachelor’s degree in a health or social science, public administration or a related field and three years of experience examining and/or processing loan applications, medical insurance or rehabilitation claims, insurance claims, collection of insurance premiums, tax collection or providing staff support in financial eligibility determination.

OR

A Master’s degree in a health or social science, public administration or a related field and two years of experience examining and/or processing loan applications, medical insurance or rehabilitation claims, insurance claims, collection of insurance premiums, tax collection or providing staff support in financial eligibility determination.

OR

A combination of education and relevant experience.

OR

One year of experience equivalent to the ES Benefits Specialist 3 with another state that administers insurance benefits programs.

AND

One year of supervisory experience.

Establishment, adopted June 22, 2023, effective July 1, 2023.