Career Opportunity

Benefits Technician - Member Services - SF Health Service System (Job Class 1209 TPV)

Recruitment: RTF0134760-01115702

Published: May 01, 2023

Accepting applications until: May 12, 2023

Apply using SmartRecruiters, the City and County of San Francisco's application portal.

About:

Appointment Type: This is a Temporary Provisional (TPV) position excluded by the Charter from the competitive Civil Service examination process. It is considered "at will" and shall serve at the discretion of the Department Head. This position will be subject to the Permanent Civil Service examination process at a later date. Successful participation in the Permanent Civil Service examination and selection through an open competitive process is needed in order to be considered for the permanent appointment.

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 136,000 lives with over 29 benefit plans from 10 different vendors. These benefits 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.

Specific information regarding this recruitment process are listed below:

Application Opening: April 24, 2023
Application Deadline: May 12, 2023
Compensation Range:  $69,108 - $84,006 annually
Recruitment ID: TPV-1209-134761

Role 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 health and dental 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 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 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.

How to qualify

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.

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.

What else should I know?

Selection Procedures:  After application submission, candidates deemed qualified must complete all subsequent steps to advance in this selection process, which includes the following:

Minimum Qualification Supplemental Questionnaire (MQSQ):
Candidates may be required to complete an MQSQ as part of the employment application. This MQSQ is designed to obtain specific information regarding an applicant's experience in relation to the Minimum Qualifications (MQ) for this position. The MQSQ will be used to evaluate if the applicant possesses the required minimum qualifications.

The selection process will include an evaluation of applications in relation to minimum requirements. Applicants meeting the minimum qualifications are not guaranteed advancement to interview. Depending on the number of applicants, the Department may establish and implement additional screening mechanisms to comparatively evaluate the qualifications of candidates. If this becomes necessary, only those applicants whose qualifications most closely meet the needs of the Department will be invited for an interview.

Applicants who meet the minimum qualifications are not guaranteed advancement through all of the steps in the selection procedure.

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” button and follow the 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 analyst, Rie.Butler@sfgov.org.

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-2021-22.pdf.

Additional Information Regarding Employment with the City and County of San Francisco: 

• Information About the Hiring Process
• Conviction History
• Employee Benefits Overview  
• Equal Employment Opportunity 
• Disaster Service Worker
• ADA Accommodation
• Veterans Preference
• Right to Work
• Copies of Application Documents
• Diversity Statement

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.