State of Maryland

An Employee Benefits Specialist I is the entry level of professional HR work in the Department of Budget and Management (DBM).  Employees in this classification perform specialized enrollment, claims issue resolution and counseling work related to the application and interpretation of laws, rules, regulations and policies governing the State’s Employee and Retiree Health and Welfare Benefits Program, which is under the jurisdiction of the Department of Budget and Management, Office of Personnel Services and Benefits. Employees in this classification learn how to handle both enrollment and customer service-related job duties. Employees in this classification do not supervise other positions.

Employees in this classification receive close supervision from a designated administrator. The work requires employees to answer frequent telephone calls and to exercise tact and diplomacy in responding to inquiries and respond calmly to heated discussions in regard to health benefits issues. Employees are required to obtain and maintain certification in SPMS policies and procedures and in the functionality of the Statewide Personnel System (SPS) in order to demonstrate knowledge, understanding and skill in the administration of the State’s Employee and Retiree Health and Welfare Benefits Program.

Positions in this classification are evaluated by using the classification job evaluation methodology. The use of this method involves comparing the assigned duties and responsibilities of a position to the job criteria found in the Nature of Work and Examples of Work sections of the class specification.

The Employee Benefits Specialist I, Employee Benefits Specialist II, Employee Benefits Specialist III, and Employee Benefits Specialist IV are differentiated on the basis of degree of supervisory control exercised by the supervisor over these employees. The Employee Benefits Specialist I learns and begins to perform duties under close supervision. The Employee Benefits Specialist II performs duties under close supervision. The Employee Benefits Specialist III performs duties under moderate supervision. The Employee Benefits Specialist IV performs the full range of duties and responsibilities under general supervision.

Reviews enrollment events or applications to ensure all required information and documentation is included and the proper coverage levels have been selected;

Rejects enrollment events or applications that do not contain required information and returns to agencies or individuals (as appropriate) for corrections or modifications;

Enters enrollment-related data into automated systems within specific time frames;

Prepares letters to participants to request official documentation to support enrollment requests;

Learns to prepare and review notification of termination events to remove participants from the health benefits database systems;

Learns to enter, retrieve and resolve help desk tickets in MOJO or similar help desk ticketing system;

Learns to advise program participants of available health benefits options in order to provide assistance with making informed health care decisions;

Learns to interpret and apply applicable health benefits rules, regulations and policies; Learns to communicate with Health Benefits Vendors to resolve participant claim coverage issues;

Learns to research participant records using computer databases, other agency and control agency information systems and identify discrepancies in the payment of deductions resulting from agency transfer or military active duty;

Learns to counsel participants and retirees in one-on-one settings and on the telephone and perform the required follow-up to provide requested information;

Learns to prepare correspondence to participants, Agency Benefits Coordinators and Health Benefits vendors in response to information requests and determinations;

Learns to complete necessary documents to ensure expeditious and effective initiation of refund payments to retirees;

Learns to inform separated participants of the option to continue health insurance coverage by application for Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985;

Learns to read and interpret the Statewide Personnel System (Workday) benefits screens, as well as navigate in the Benefits Administration System for the purpose of answering inquiries and performing benefits-related tasks;

Learns how to navigate in and use other systems, such as MOJO and Velocity;

Performs other related duties.    

Knowledge of office procedures, business English, spelling, grammar and arithmetic;

Ability to learn Health Benefits Program plans, rules, regulations, and policies;

Ability to learn federal and State laws relating to health benefits coverage;

Ability to learn retirement-related State laws/regulations/policies as these relate to health benefits administration;

Ability to interpret and apply State Central Payroll regulations;

Ability to provide exceptional customer service;

Ability to identify and correct errors regarding information provided by participants, State agencies, Health Benefits Vendors and others;

Ability to learn and navigate proficiently in a variety of system applications, such as: MOJO (or similar help desk ticketing system), Benefits Administration System, Workday and Velocity (or similar online payment system);

Ability to accurately analyze and address the issues presented by participants and other interested parties;

Ability to communicate effectively;

Ability to establish and maintain effective working relationships with co-workers, division staff, other government officials and the general public;

Ability to exercise tact and discretion in dealing with State employees, retirees, dependents, co-workers, the general public, and government officials.

Experience: One year of experience working in a customer service environment.

Note: Candidates may substitute the possession of a Bachelor's degree from an accredited college or university for the required experience. 

1. Employees in this classification are required to obtain certification in State Personnel Management System policies and procedures and in the functionality of the Statewide Personnel System from the Office of Personnel Services and Benefits, DBM within six months from the time of appointment to the position.  Employees also are required to obtain recertification every six months thereafter.

2. Employees in this classification may be assigned duties which require the operation of a motor vehicle. Employees assigned such duties will be required to possess a motor vehicle operator’s license valid in the State of Maryland.

Class specifications are broad descriptions covering groups of positions used by various State departments and agencies. Position descriptions maintained by the using department or agency specifically address the essential job functions of each position.

This is a Skilled Service classification in the State Personnel Management System.  All positions in this classification are Skilled Service positions.  Some positions in Skilled Service classifications may be designated Special Appointment in accordance with the State Personnel and Pensions Article, Section 6-405, Annotated Code of Maryland.

This classification is not assigned to a bargaining unit, as indicated by the designation of S (Supervisor), M (Manager), T (Agency Head), U (Board or Commission Member), W (Student), X (Used by Agency or Excluded by Executive Order), or Z (Confidential).  As provided by State Personnel and Pensions Article, Section 3-102, special appointment, temporary, contractual, supervisory, managerial and confidential employees are excluded from collective bargaining. Additionally, certain executive branch agencies are exempt from collective bargaining and all positions in those agencies are excluded from collective bargaining.

Employees in this classification are eligible to receive overtime compensation. An employee who works more than the normal workweek is entitled to be compensated for that overtime, as provided by the State Personnel and Pensions Article, Section 8-305.