What are the responsibilities and job description for the Benefits Specialist position at Southwell, Inc.?
DEPARTMENT: HUMAN RESOURCES
F ACILITY: Medical Office Building
WORK TYPE: Full Time
S HIFT: Daytime
HOURS:
SUMMARY:
Assists in monitoring benefit programs offered. Assists with HR policies and procedures, orientation, premium billing reconciliation, and participates in performance improvement activities.
RESPONSIBILITIES:
* Assists in monitoring and maintaining current benefit plans.
- Participates in Employee General Orientation and Special One-on-One Orientations.
- Updates eligibility of members with the third party administrator (TPA) according to the Plan Document for claims.
- Advises and assist employees with benefit questions or policies.
- In the absence of the Benefits Manager, explains benefit options to new employees to include cost to employee, enrollment process, effective date of coverage, etc.
- Audits accuracy of information and eligibility for benefits before sending to various third party administrators (TPAs), and follows-up on discrepancies in forms.
- Processes employee group health, vision, dental, TDA, life insurance enrollments. Assists with AFLAC and voluntary benefits.
- Assists with AFLAC and voluntary benefits.
- Issues benefit packets to eligible employees to include identification cards, plan documents, and various other information.
- Assists in the preparation of the Benefit Fair.
- Maintains adequate supply of benefit forms.
- Send completed forms to TDA representative in a timely manner.
- Processes change forms and ensures that changes are made in the electronic records.
- Tracks and maintains 120 day evaluation records.
- Audits group benefit billing reports for accuracy and completeness, and follows-up with discrepancies in forms.
- Reviews insurance claim issues for employees and follows up in a timely manner.
- Submits termination listing for vesting to appropriate company monthly.
- Processes COBRA payments and computes COBRA reports on a monthly basis.
- Notifies insurance carriers of terminations and/or changes (enters in various systems as needed).
- Maintains confidentiality of department information according to established procedure.
- Releases confidential information only in accordance with hospital policy.
- Assures security of departmental and administrative policies.
- Serves as liaison between hospital employees and benefit providers. Keeping AVP and Benefits informed of all problems and research activities.
- Reports unsafe conditions immediately to appropriate party.
- Knows emergency procedures for fire, safety, hazardous material utility system failure, and disasters.
- Keeps abreast of pertinent federal, and state regulations and laws and Tift Regional Health System, Inc. (“TRHS”) policies as they presently exist and as they change or are modified.
- Understands and adheres to: TRHS’ compliance standards as they appear in TRHS’s Corporate Compliance Policy, Code of Conduct and Conflict of Interest Policy; and HIPAA and TRHS policies regarding privacy and security of protected health information.
- Demonstrates the ability to perform tasks that meet the age-specific requirements of the persons, patients, vendors, and staff that the employee is charged to interact with as required by the position.
- Offers suggestions on ways to improve operations of department and reduce costs.
- Attends all mandatory education programs.
- Improves self-knowledge through voluntarily attending continuing education/certification classes.
- Maintains required competency levels as identified in written exams, skills checklists, skills labs, annual safety and health requirements as well as service excellence education hours requirements.
- Cross-trains in order to better assist co-workers and to provide maximum efficiency in the department.
- Volunteers/participates on hospital committees, functions, and department projects.
- Manages resources effectively.
- Reports equipment in need of repair in order to extend life of equipment and removes malfunctioning equipment out of service with timely reporting to the appropriate personnel.
- Makes good use of time so as to not create needless overtime.
EDUCATION:
* High School Diploma or Equivalent
OTHER INFORMATION:
Two years of clerical experience preferred.
Southwell/Tift Regional Health System, Inc. is an Equal Opportunity Employer.
