Career Opportunity

Benefits Technician - Member Services Division - San Francisco Health Service System (1209)

Recruitment: REF9898D

Published: April 18, 2022

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

About:

This is a Position Based Test conducted in accordance with Civil Service Commission Rule 111A. 

Specific information regarding this recruitment process are listed below:

• Application Opening: 4/15/2022
• Application Deadline: 4/28/2022
• Compensation: $65,650 - $79,820 annually 1209 Class & Comp Info
• Recruitment ID: PBT-1209-112190

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.

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

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.”

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

• Minimum Qualifications Supplemental Questionnaire [MQSQ] - Candidates will be required to complete a 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.
• Supplemental Questionnaire [SQ] (100% weight) - Candidates who meet the Minimum Qualifications and complete the MQSQ will be sent an SQ to complete and return. The SQ has been designed to measure knowledge, skills and/or abilities in job-related areas. The SQ will be rated and scored. All relevant experience, education and/or training must be on the SQ in order to be reviewed in the rating process.

Note: Candidates must achieve a passing score on the selection components described above in order to move forward in the selection process.

What else should I know?

In line with the Official Public Health Order to slow the spread of COVID-19, “shelter-in-place” has been issued for all San Francisco residents that is expected to be in effect until further notice. As a result, Department of Human Resources (DHR)’s office (located at 1 South Van Ness Avenue, 4th Floor, San Francisco, CA 94103) is currently closed to the general public. If you have any questions, please feel free to email the Human Resources Analyst listed on this announcement. 

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 of 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-2021-22.pdf.

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.smartrecruiters.com/CityAndCountyOfSanFrancisco1/ .

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:

Conviction History
Disaster Service Workers
Equal Employment Opportunity 
Information on requesting a reasonable ADA Accommodation
Veteran's Preference
Seniority Credit in Promotional Exams
General Information concerning City and County of San Francisco Employment Policies and Procedures
Copies of Application Documents
Right to Work
Diversity Statement
Position Based Testing Information
Benefits Overview

HOW TO APPLY

Applications for City and County of San Francisco jobs are only accepted through an online process. Visit https://careers.smartrecruiters.com/CityAndCountyOfSanFrancisco1/ and begin the application process.

• Select the “I’m Interested” 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, Christine Salam at christine.salam@sfgov.org or (415) 557-4881.

Carol Isen - Human Resources Director

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.