Life and Accident Specialist - Utah Retirement Systems

PEHP Health & Benefits is a division of the Utah Retirement Systems that proudly serves Utah’s public employees through high quality and competitively priced medical, dental, life, and long-term disability insurance plans on a self-funded basis.   As a government entity, we embrace both a public mission and a commitment to creating customer value, excelling in the market, and improving healthcare.   We offer a competitive salary with generous benefits, personal development in a positive team environment, and excellent work-life balance.

Summary:

Performs a variety of clerical and administrative duties to expedite the processing of the life insurance enrollment.  Reviews life and accident insurance enrollments, coordinates continuation of life benefits and participates in annual open enrollment activities.

Duties and Responsibilities:

1. Receives and reviews life and accident insurance enrollment, determines degree of completion, and reviews premium statistics to ensure data transmitted by employers reconciles to the database. 
2. Updates program for approved coverage levels and prepares enrollment documents for scanning.
3. Accesses imaged documents to resolve enrollment discrepancies to determine enrollment/eligibility status and respond to member or employing unit questions.
4. Retrieves medical and pharmacy history from the PEHP system. 
5. Prepares tracking sheets and assembles necessary documents for conducting an underwriting review.
6. Coordinates continuation of life benefits for employees terminating group coverage. 
7. Responds to member and employee unit questions on laws/rules. 
8. Coordinates eligibility and billing with accounting personnel.
9. Receives and processes requests for refunds due to overpayment of premiums, coordinates with accounting personnel as needed. 
10. Performs online updates on State payroll system to begin or revise deductions as needed. 
11. Coordinates life enrollment for State exempt life, researches for members with dual coverage to ensure maximum amount is not exceeded. 
12. Generates pending death claims report, error report and biweekly termination reports and makes necessary enrollment and deduction changes.
13. Contacts various member units as needed to resolve discrepancies related to forms and applications.
14. Generates letters informing them of age change that would effect payroll deductions.
15. Participates in annual open enrollment activities and benefit fairs.  Assists to communicate benefit programs, provides customer service in the life insurance call group. 
16. Mails life insurance certificates and coverage letters to members. 
17. Provides administrative backup support to the life operations supervisor.
18. Maintains strict confidentiality.
19. Performs other related duties as required.

Education and Experience

High School diploma and one (1) year of related experience within the insurance industry, administrative experience, or an equivalent combination of education and experience.

Enrollment and Claims Processing experience preferred.

Knowledge, Skills, and Abilities

Requires some knowledge of purposes, principles and practices of public insurance systems; enrollment programs and processes; insurance laws; computer software applications; general office practices and procedures; alpha and numeric recording system; basic public relations; basic typing skills; telephone etiquette; bookkeeping and related statistical procedures.

Must have the ability to analyze and solve problems relating to member enrollment status; communicate effectively both verbally and in writing regarding a variety of insurance issues and programs; ability to follow written and verbal instructions; establish and maintain effective working relationships with supervisors, managers, co-workers and the public; perform basic mathematical calculations; operate a variety of types of office equipment including computer terminal, calculators, etc.; work independently and deal effectively with stress caused by workload and time deadlines.

Position requires occasional travel for office business.  Individual must be physically capable of safely operating a vehicle, possess a valid driver’s license and have an acceptable driving record based upon data provided by a current Department of Motor Vehicle Record (MVR).

Work Environment

Incumbent performs in a typical office setting with appropriate climate controls. Tasks require a variety of physical activities which do not generally involve muscular strain, but do require activities related to walking, standing, stooping, sitting, reaching, talking, hearing and seeing. Common eye, hand, finger dexterity required to perform essential functions.