Disability/Recoveries Administrative Assistant

Utah Retirement Systems•Salt Lake City, UT

2d•Hybrid

About The Position

This position plays a critical role in PEHP’s efforts to serve and create value for our members by helping them understand their benefits, resolve problems, and assisting with requests for benefit eligibility. Performs a variety of administrative duties and data entry for compiling disability claim files, obtaining medical records, and tracking premium payments. Responsible for various administrative tasks, data entry, and reviews related to third party liability and overpayment recovery. This position requires strong organizational skills and the ability to manage diverse tasks in a supportive role. Successful performance for this position requires a genuine interest in helping others, a high level of commitment, attention to detail, and the ability to learn about and share complex information.

Requirements

High School diploma and two (2) years of experience performing a variety of clerical, technical, and administrative duties; or an equivalent combination of education and experience.
Working knowledge and ability of various office management systems related to alpha and numeric record keeping and data entry.
Working knowledge and ability of computer operations and technical software applications.
Working knowledge and ability of Microsoft Office Suite.
Working knowledge and ability of 10 key calculators.
Type 40 wpm.
Working knowledge of intermediate math skills in calculating figures and amounts such as discounts, interest, proportions, and percentages.
Working knowledge of employer premium percentages and accuracy.
Working knowledge of statistical analysis for trending.
Working knowledge of COLA calculations.
Working knowledge of basic bookkeeping.
Excellent communication skills: Read, analyze, and interpret general business periodicals, technical procedures, and regulations.
Excellent communication skills: Write reports, business correspondence, and procedure manuals.
Excellent communication skills: Create presentations and documentation for LTD Manager. Occasional presentations to internal departments.
Excellent communication skills: Present complex scenarios and consequences to members, peers, managers, health providers, outside adjusters, and other carriers.
Interpersonal skills in working with claimants, employers, outside claim adjusters, health providers, internal managers, and co-workers.
Knowledge of business grammar, spelling, letter composition, and telephone etiquette.
Working knowledge of insurance principles.
Working knowledge of medical, dental, pharmacy, and Medicare supplement claim adjudication policies, procedures, and processes.
Working knowledge of policy and COB provisions and regulations.
Working knowledge of CPT and ICD-10 coding.
Ability to deal with claimant medical and financial information with sensitivity, confidentiality, and discretion.
Ability to follow written and verbal instructions.
Ability to organize and prioritize work.
Ability to quality control peer math calculations.
Ability to perform within deadlines.
Ability to work well in a team environment as well as independently.
Ability to establish and maintain effective working relationships with professionals, executives, department heads, coworkers, and the public.
Ability to multi-task by handling a variety of duties in a timely and efficient manner.
Ability to follow through with assignments.
Ability to deal effectively with stress caused by workload and time deadlines.
Must demonstrate judgment, high integrity, and personal values consistent with the values of URS.

Nice To Haves

Specific experience in LTD/time-loss insurance claims
Advanced knowledge of personal computer operations
Medical/dental terminology

Responsibilities

Monitors, documents, and quality checks premium payments from participating employers. Contacts employers regarding delinquent payments/errors and sends demand letters. Assists with monthly audit process of premium payments.
Maintains and calculates annual review of COLA increases for beneficiaries and mails notifications.
Processes mail, data entry, receives phone inquiries, answers general questions, maintains claim diaries of tasks, provides administrative and clerical support and prepares routine and specialized correspondence.
Assists Disability Specialists with monthly payroll audit, claims updates, and annual W-2 process.
Maintains pending disability applications to include creating electronic files, notifies and obtains information from employers and URS, requests medical records, and pays record invoice.
Maintains electronic files in Laserfiche and quality checks imaging process.
Prepares files and documentation for medical consultant reviews, vocational reviews, and clinical visits.
Compiles data spreadsheets for pending claims and file reviews.
Compiles data spreadsheets for outside collection vendor for placement of member and provider overpayments.
Runs departmental monthly reports and completes required tasks.
Reviews existing refund requests for medical/dental claims for receipt.
Processes refund requests for medical/dental overpayments.
Processes deductions for PEHP medical and dental.
Places holds on member claims related to third party liability, creates documentation and correspondence and performs follow-up tasks through phone calls, email and/or letters.
Performs other related duties as required.
Maintains regular and reliable attendance.
Maintains strict confidentiality.