Benefits Technician - Access to City Employment (ACE) (1209)
Published: November 01, 2022
Apply using SmartRecruiters, the City and County of San Francisco's application portal Learn More
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.
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 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. Skill to: access and use computer software applications and database systems.
How to qualify
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 & Training:
1. Completion of two (2) years college-level course work; AND
2. 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
3. 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.
Possess certificate of completion of foundational Medical-Only Workers Compensation coursework through Insurance Educational Association (IEA) or comparable entity.
What else should I know?
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.
CONDITION OF EMPLOYMENT: All City and County of San Francisco employees are required to be fully vaccinated against COVID-19 as a condition of employment. Someone is fully vaccinated when 14 days have passed since they received the final dose of a two-shot vaccine or a dose of a one-shot vaccine. Any new hire must present proof of full vaccination status to be appointed. Any new hire who will be routinely assigned or occasionally enter High-Risk Settings, must provide proof of having received a COVID-19 booster vaccine by March 1, 2022, or once eligible.
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.