Benefits Technician – SF Health Service System (1209) - (139888)
Job Description
Under immediate supervision, the Benefits Technician performs technical and clerical work in employee benefits for the City's Health Service System and performs related duties as required. Member interaction includes in-person and telephone contact. Essential functions include: providing support services to analysts 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 member and/or dependent plan enrollment; performing various calculations; completing standard form letters; and maintaining reports, logs and records.
Typical tasks include:
1. Provides support services to analysts in processing claims and benefit entitlements.
2. Provides general information to City employees regarding health and dental benefits.
3. Researches records and accounts for prior membership, premium history, account discrepancies, requested information, payment history, overpayments, underpayments, 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 eligibility forms.
6. Conducts research on claims to determine appropriate rates to use for payment and refers claims needing further attention to an analyst or supervisor.
7. Performs various calculations to support the determination of health services 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 inquires on unpaid medical invoices and enrollment eligibility.
10. Completes standard form letters, and maintains reports, logs, and records.
11. Performs related duties and responsibilities as assigned.
Qualifications
Education: Completion of two (2) years college-level course work.
SUBSTITUTION: 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 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.
One year of full-time employment is equivalent to 2,000 hours. (2,000 hours of qualifying work experience is based on a 40-hour work week.) Any overtime hours that you work above forty (40) hours per week are not included in the calculation to determine full-time employment.
Desirable Qualifications:
The stated desirable qualifications may be considered at the end of the selection process when candidates are referred for hiring:
Verification of Education and Experience:
Applicants may be required to submit verification of qualifying education and experience at any point during the recruitment and selection process. If education verification is required, information on how to verify education requirements, including verifying foreign education credits or degree equivalency, can be found at https://sfdhr.org/how-verify-education-requirements.
Note: 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.
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.
Resumes will not be accepted in lieu of a completed City and County of San Francisco application.
Applications completed improperly may be cause for ineligibility, disqualification or may lead to lower scores.
_ Selection Procedures:_
After application submission, candidates deemed qualified must complete all subsequent steps to advance in this selection process, which includes the following:
Note: Candidates must achieve a passing score on the selection components described above in order to move forward in the selection process.
Additional Information
Eligible List/Score Report: A confidential eligible list of applicant names that have passed the civil service examination process will be created, and used for certification purposes only. An examination score report will be established, so applicants can view the ranks, final scores and number of eligible candidates. Applicant information, including names of applicants on the eligible list, shall not be made public unless required by law. However, an eligible list shall be made available for public inspection, upon request, once the eligible list is exhausted or expired and referrals resolved. The eligible list/score report resulting from this civil service examination process is subject to change after adoption (e.g., as a result of appeals), as directed by the Human Resources Director or the Civil Service Commission.
The duration of the eligible list resulting from this examination process will be 6 months , and may be extended with the approval of the Human Resources Director.
To find Departments which use this classification, please see https://sfdhr.org/sites/default/files/documents/Forms-Documents/Position-Counts-by-Job-Codes-and-Department-FY-2023-24.pdf .
Certification: The certification rule for the eligible list resulting from this examination will be Rule of Three. The hiring department may administer additional position-specific selection procedures prior to making final hiring decisions.
Terms of Announcement and Appeal Rights: Applicants must be guided solely by the provisions of this announcement, including requirements, time periods and other particulars, except when superseded by federal, state or local laws, rules or regulations. Clerical errors may be corrected by the posting the correction on the Department of Human Resources website at https://careers.sf.gov/.
The terms of this announcement may be appealed under Civil Service Rule 111A.35.1. The standard for the review of such appeals is ‘abuse of discretion’ or ‘no rational basis’ for establishing the position description, the minimum qualifications and/or the certification rule. Appeals must include a written statement of the item(s) being contested and the specific reason(s) why the cited item(s) constitute(s) abuse of discretion by the Human Resources Director. Appeals must be submitted directly to the Executive Officer of the Civil Service Commission within five business days of the announcement issuance date.
Additional Information Regarding Employment with the City and County of San Francisco:
HOW TO APPLY
Applications for City and County of San Francisco jobs are only accepted through an online process. Visit https://careers.sf.gov/ and begin the application process.
• Select the "I'm Interested," or “Apply Now” button and follow instructions on the screen
Applicants may be contacted by email about this recruitment 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, @smartalerts.info, and @smartrecruiters.com).
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.
If you have any questions regarding this recruitment or application process, please contact the exam analyst, Stella Choi at stella.choi@sfgov.org.
The City and County of San Francisco encourages women, minorities and persons with disabilities to apply. Applicants will be considered regardless of their sex, race, age, religion, color, national origin, ancestry, physical disability, mental disability, medical condition (associated with cancer, a history of cancer, or genetic characteristics), HIV/AIDS status, genetic information, marital status, sexual orientation, gender, gender identity, gender expression, military and veteran status, or other protected category under the law.