1209 Benefits Technician

Recruitment #TEX-1209-111059

Introduction

This is a Temporary Exempt (TEX) appointment. Exempt employees are considered “at will” and serve at the discretion of the appointing officer. The San Francisco Health Service System.

The San Francisco Health Service System (SFHSS) provides health benefits for SFHSS members - employees and retirees - of the City and County of San Francisco, the San Francisco Unified School District, San Francisco City College and the San Francisco Superior Court, and their dependents. Staff must know and administer benefits for 126,000 lives with over 29 benefit plans from 10 different vendors. These benefit plans include Medicare and Non-Medicare medical, dental, vision benefits, as well as life insurance, long-term disability benefits, flexible spending accounts for health and dependent care and COBRA. SFHSS is dedicated to providing outstanding health and other employee benefits to its members while adhering to the highest standards of customer service. The SFHSS is currently seeking temporary, full-time 1209 Benefit Technician positions.

Position Description
Under immediate supervision, performs technical and clerical work in employee benefits for the City's Health Service System and performs related duties as required. Essential functions include: providing support services to analysts or adjusters in processing claims and benefit entitlements; providing general information to City employees regarding benefits; communicating with employees and representatives from various departments and outside agencies; researching and reconciling records and accounts; making adjustments and performing database maintenance; reviewing, completing and processing a variety of membership forms and medical claims; performing various calculations; completing standard form letters; and maintaining reports, logs and records.

Typical tasks include:

1. Provides support services to analysts or adjuster in processing claims and benefit entitlements.
2. Provides general information to City employees regarding retirement benefits, health and dental benefits, or worker's compensation benefits.
3. Researches records and accounts for prior membership, premium history, account discrepancies, requested information, buybacks, withdrawal status, payment history, prior claims, overpayments, underpayments, injury information, and adjustments in database.
4. Makes adjustments, and creates, updates, inputs, and maintains information in the computer software files or in the database.
5. Reviews, completes, and processes a variety of membership forms, medical claims, and medical only (worker's compensation) claims.
6. Conducts research on claims to determine appropriate rates to use for payment and refers claims needing further attention to an analyst or claim examiner.
7. Performs various calculations to support the determination of retirement, health services, or worker's compensation benefits.
8. Communicates with employees, dependents, human resources, and payroll personnel within citywide departments, representatives from outside agencies, medical practitioners, lawyers, and other professionals.
9. Responds to routine vendor and claimant tracer inquires on unpaid medical invoices and medical only claims.
10. Completes standard form letters, and maintains reports, logs, and records.
11. Acts as a verifier to check work performed by another technician at the end of the day.
12. Performs related duties and responsibilities as assigned.

Minimum Qualifications

Education: Completion of two (2) years college-level course work; AND

Experience: One (1) year of verifiable clerical or technical experience administering employee benefits programs including: researching records, claims adjudication, database maintenance, reviewing forms, performing calculations, and responding to general inquiries; AND

Proficiency in the use of computers to perform word processing and to perform data entry/retrieval.

SUBSTITUTION: Additional experience as described above may be substituted for the required education on a year-for-year basis. Thirty (30) semester units/forty-five (45) quarter units equal one year of experience.

How To Apply

Applications for City and County of San Francisco jobs are only accepted through an online process. Visit www.jobaps.com/sf to register an account (if you have not already done so) and begin the application process.

  • Select the desired job announcement.
  • Select "Apply" and read and acknowledge the information.
  • Select either "I am a New User" if you have not previously registered, or "I have Registered Previously."
  • Follow instructions on the screen.

In line with the Official Public Health Order to slow the spread of COVID-19, “shelter-in-place” has been issued for all San Francisco residents that is expected to be in effect until further notice.  As a result, Department of Human Resources (DHR)’s office (located at 1 South Van Ness Avenue, 4th Floor, San Francisco, CA 94103) is currently closed to the general public. If you have any questions, please feel free to email the Human Resources Analyst listed on this announcement.

Applicants may be contacted by email about this announcement and, therefore, it is their responsibility to ensure that their registered email address is accurate and kept up-to-date. Also, applicants must ensure that email from CCSF is not blocked on their computer by a spam filter. To prevent blocking, applicants should set up their email to accept CCSF mail from the following addresses (@sfgov.org, @sfdpw.org, @sfport.com, @flysfo.com, @sfwater.org, @sfdph.org, @asianart.org, @sfmta.com, @sfpl.org, @dcyf.org, @first5sf.org, @famsf.org, @ccsf.edu).

Applicants will receive a confirmation email that their online application has been received in response to every announcement for which they file. Applicants should retain this confirmation email for their records. Failure to receive this email means that the online application was not submitted or received.

All work experience, education, training and other information substantiating how you meet the minimum qualifications must be included on your application by the filing deadline. Information submitted after the filing deadline will not be considered in determining whether you meet the minimum qualifications.

Applications completed improperly may be cause for ineligibility, disqualification or may lead to lower scores.

If you have any questions regarding this recruitment or application process, please contact Christine Salam, by telephone at 415-557-4881, or by email at christine.salam@sfgov.org.

VERIFICATION
Applicants may be required to submit verification of qualifying education and experience at any point during the recruitment and selection process, prior to being appointed into the position. If education verification is required, information on how to verify education requirements, including verifying foreign education credits or degree equivalency, can be found at http://sfdhr.org/index.aspx?page=456. Employment verification letters should be in the company letterhead, stating the inclusive dates of service and positions held as it relates to the qualifying experience required to be considered for the position.

NOTES

  • The selected applicant will need to verify qualifying education and/or experience prior to being appointed into the position.
  • Falsifying one’s education, training, or work experience or attempted deception on the application may result in disqualification for this and future job opportunities with the City and County of San Francisco.

Selection Procedures

Applications will be screened for relevant qualifying experience. Additional screening mechanisms may be implemented in order to determine the applicants’ qualifications. Only those applicants whose backgrounds best match the position will be invited to participate in the selection process. Applicants meeting the minimum qualifications are not guaranteed advancement in the selection process.

Conviction History

As a selected candidate for a job, you will be fingerprinted, and your fingerprints will be sent to the California Department of Justice (DOJ) and the Federal Bureau of Investigation (FBI). The resulting report of your conviction history (if any) will be used to determine whether the nature of your conviction (or arrest, in limited circumstances) conflicts with the specific duties and responsibilities of the job for which you are a selected candidate. If a conflict exists, you will be asked to present any evidence of rehabilitation that may mitigate the conflict, except when federal or state regulations bar employment in specific circumstances, such as:

  • Candidates for positions with the Unified School District and the Community College District may be disqualified from consideration should their conviction history not meet the standards established under the California Education Code.
  • Candidates for positions with the Recreation and Park Department may be disqualified from consideration should their conviction history not meet the standards established under California Public Resources Code 5164.

Having a conviction history does not automatically preclude you from a job with the City.

If you are a selected candidate, the hiring department will contact you to schedule a fingerprinting appointment.

Disaster Service Workers

All City and County of San Francisco employees are designated Disaster Service Workers through state and local law (California Government Code Section 3100-3109). Employment with the City requires the affirmation of a loyalty oath to this effect. Employees are required to complete all Disaster Service Worker-related training as assigned, and to return to work as ordered in the event of an emergency.

Benefits

All employees hired on or after January 10, 2009 will be required (pursuant to San Francisco Charter Section A8.432) to contribute 2% of pre-tax compensation to fund retiree healthcare. In addition, most employees are required to make a member contribution towards retirement, ranging from 7.5%-13.25% of compensation. For more information on these provisions, please contact the personnel office of the hiring agency.

For more information about benefits, please click here.

 



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