Benefits Member Services Specialist

Arizona Department of Administration • Phoenix, AZ

3d • Onsite

About The Position

The Arizona Department of Administration (ADOA) is seeking a dedicated and analytical professional to join the Benefits Services Division (BSD) as a Benefits Member Services Specialist. In this vital role, you will serve as a primary advocate and guide for our diverse member base, providing expert counsel to active state employees, retirees, long-term disability participants, and COBRA beneficiaries. Working with a high degree of independence, you will navigate the complexities of state benefit programs to deliver clear, actionable information to members both over the phone and in person. You won’t just answer questions; you will act as a skilled problem-solver, reconciling data across multiple accounting systems and collaborating with key partners such as ASRS, PSRS, CORP, Arizona’s three state universities, and the General Accounting Office. The ideal candidate possesses the critical thinking skills necessary to interpret intricate insurance policies and apply legal frameworks to make accurate coverage determinations. If you are passionate about helping others navigate their healthcare and insurance journeys while mastering the technical nuances of large-scale benefit systems, we encourage you to apply and help us support those who serve Arizona.

Requirements

• Knowledge of: State statutes, State Personnel Rules, and agency policies and procedures.
• State and Federal insurance contract requirements.
• Insurance programs.
• AZ360 system.
• Skills in: Basic accounting and auditing procedures.
• Call center operations.
• Utilizing various computer applications.
• Analyzing, interpreting, and applying laws, rules, and regulations applicable to the system.
• Effective verbal and written communication skills necessary to provide clear and detailed information in response to a broad variety of requests for information.
• Organizational skills.
• Interpersonal skills.
• Ability to: Provide quality customer service.
• Understand State of Arizona Benefits Services Division policies and procedures.
• Establish and maintain effective working relationships.
• Adapt to continually changing circumstances.
• Office management and some database management.

Nice To Haves

• One year of customer service or equivalent prior Benefits experience, including the understanding of insurance programs, call center operations, knowledge of the AZ360 system, and understanding of Benefits Services Division policies and procedures.

Responsibilities

• Provide Expert Consultation: Exercise professional judgment within established guidelines to resolve complex member inquiries received via telephone, in-person consultations, digital applications, and written correspondence.
• Policy Interpretation: Effectively explain intricate system policies, benefit programs, and coverage nuances to active employees, retirees, and COBRA participants.
• Eligibility Determination: Utilize multiple integrated computer systems to evaluate and verify insurance coverage eligibility for diverse member groups.
• Financial Accuracy: Apply foundational accounting principles to calculate precise payroll deductions, identify payment overages, and facilitate the processing of collections and refunds.
• System Integration: Navigate and reconcile data across disparate payroll systems and external partner agencies, including ASRS, PSRS, CORP, state universities, and the General Accounting Office (GAO).
• Legal Application: Analyze complex coverage issues by applying the legal aspects of insurance policies and State Personnel Rules to reach formal coverage determinations.
• Resource Management: Leverage internal and external resources to troubleshoot and resolve systemic insurance discrepancies and member account issues.
• Open Enrollment Support: Assist in the strategic development and distribution of Open Enrollment materials and communications.
• Process Improvement: Participate in organizational initiatives to enhance service delivery and streamline administrative workflows.
• Policy Development: Contribute to the review and revision of Benefits Member Services standard operating procedures and internal policies.

Benefits

• Sick leave
• Vacation with 10 paid holidays per year
• Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program)
• Health and dental insurance
• Retirement plan
• Life insurance and long-term disability insurance
• Optional employee benefits include short-term disability insurance, deferred compensation plans, and supplemental life insurance
• Participation in ASRS Lifetime Benefit Pension Plan after 26 weeks of employment.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed