Benefits Consultant

State of Kansas•Shawnee, KS

33d•$20 - $21

About The Position

The SEHP Membership unit is responsible for enrolling over 80,000 employees and family members managed by the Membership Services Team. The Membership Services Team is responsible for providing the resources and support for this population's daily eligibility and membership functions, annual open enrollment, and initial setup and enrollment. The Program Consultant position is in the State Employee Health Benefits Program (SEHBP) and reports to the Senior Manager of the State Employee Health Plan (SEHP} Membership Services. Currently, the Program Consultant position distinguishes between State and Non-State employee groups, each with distinct duties. The redistribution of duties for this position will encompass both state and non-state employee groups to provide for cross-training and backup of assigned duties. This change will enhance operational efficiency and foster a more collaborative and inclusive work environment.

Requirements

High school diploma or GED and 6 months of experience in business, public health or related field. Education may be substituted for experience as determined relevant by the agency.
A valid driver's license is required.
The incumbent will receive training in the provision of the HIPAA Privacy Regulations and HIPAA Security Regulations as they relate to the duties of this position and is required to sign a confidentiality agreement.

Responsibilities

Interpret group health insurance (GHI) policies and procedures established by the Health Care Commission (HCC} in accordance with federal and state law, statutes, and regulations, including Medicare and COBRA, to determine eligibility for Non-State employer (NSE} groups and members under the State Employee Health Plan (SEHP}. Meet deadlines, standards, and regulations set by federal and state law, HCC, and SEHP. Approve and enter new enrollments, terminations, life event changes, and membership/eligibility data into the Membership Administration Portal (MAP).
Process dashboard requests daily and ensure all the correct membership documentation/correspondence is uploaded to members' records in MAP. Generate program correspondence as needed to members and human resources (HR) representatives. Review members' submitted communication for appeals, corrections, and requests for exceptions under the SEHP. Present and discuss exceptions with the supervisor. Contact carriers and other vendors with urgent membership eligibility issues and updates. Errors may result in members having incorrect or no coverage, incorrect employer and employee contributions for premiums, incorrect claims administration by carriers, and potential violations of federal and state laws, statutes, and regulations.
Receives various COBRA reports and takes the appropriate action in MAP. Verify and make necessary corrections to COBRA membership data entered in MAP. Contact carriers with urgent membership updates. Errors may result in members having incorrect or no coverage, incorrect premium billing for members, and violations of the COBRA laws.
Perform other special projects as assigned and required, including but not limited to:
Participate in the design and content of open enrollment materials, including information for the SEHP website.
Provide input on revisions to the Administrative Manual, Employee Guidebook
Generate reports in MAP, create the appropriate letters, and process changes as needed.
Other duties as assigned.

Benefits

Comprehensive medical, mental, dental, vision, and additional coverage
Sick & Vacation leave
Work-Life Balance programs: parental leave, military leave, jury leave, funeral leave
Paid State Holidays (designated by the Governor annually)
Fitness Centers in select locations
Employee discounts with the STAR Program
Retirement and deferred compensation programs

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