1209-Benefits Technician

Job description

CITY AND COUNTY OF SAN FRANCISCO

DEPARTMENT OF HUMAN RESOURCES

JOB CODE TITLE: BENEFITS TECHNICIAN

JOB CODE: 1209

DEFINITION

Under immediate supervision, performs technical and clerical work in employee benefits for the City's Health Service System, Retirement System, or Workers' Compensation Program 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.

DISTINGUISHING FEATURES

Class 1209 Benefits Technician is the entry-level class of the Employee Benefits series performing technical and administrative support and research. This class is distinguished from the 1210 Benefits Analyst in that the latter is a professional journey level class responsible for performing complex analytical duties in benefits administration.

SUPERVISION EXERCISED

None.

EXAMPLES OF IMPORTANT AND ESSENTIAL DUTIES

According to Civil Service Commission Rule 109, the duties specified below are representative of the range of duties assigned to this job code/class and are not intended to be an inclusive list.

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.

KNOWLEDGE, SKILLS, AND ABILITIES

Knowledge of: basic technical knowledge of employee benefits programs such as pension plans, worker's compensation, labor code, and medical terminology.

Ability or Skill to: perform accurate calculations following a prescribed format; problem solve to identify problems and make routine adjustments; research to gather meaningful information and perform routine analysis; speak and write in a clear, concise, and understandable manner to answer benefits questions; and establish and maintain effective working relationships, and assist in a polite, courteous manner.

MINIMUM QUALIFICATIONS

These minimum qualifications establish the education, training, experience, special skills and/or license(s) which are required for employment in the classification. Please note, additional qualifications (i.e., special conditions) may apply to a particular position and will be stated on the exam/job announcement.

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.

SUPPLEMENTAL INFORMATION

PROMOTIVE LINES

ORIGINATION DATE:

November 17, 1994

AMENDED DATE:

September 29, 2000; June 25, 2000; July 11, 2023

REASON FOR AMENDMENT:

To accurately reflect the current tasks, knowledge, skills & abilities, and minimum qualifications.

BUSINESS UNIT(S):

COMMN SFMTA

Standard information

Disaster service work

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.

Historic and future compensation