Group Benefits Analyst 1, 2, Or 3

State of Louisiana•Baton Rouge, LA

3d•Onsite

About The Position

The Division of Administration/Office of Group Benefits has a vacancy for a Group Benefits Analyst in the Customer Services Section. This position is responsible for providing support functions through call center operations, emails, postal mail, and walk-ins. The role assists with the DHH LACHIP program, addressing complex eligibility, premium issues, and dependent verification. It may also handle complex Medicare and Medicaid cases, involving intricate federal and state guidelines, timelines, coordination of benefits, and problem resolution. The Office of Group Benefits manages a comprehensive, employer-based benefits program for over 230,000 individuals associated with the State of Louisiana, school boards, and other governmental subdivisions. OGB's management functions include overseeing third-party administrators (TPAs) to ensure program cost containment and compliance with mandates, maintaining insurance plan documents, monitoring administrative costs, and recommending cost-saving strategies or alternative administration methods. The Division of Administration serves as the state government's management arm and financial operations hub, overseeing capital construction, community development grants, budget development, technology services, purchasing and contracting guidance, and disaster recovery funding.

Requirements

Three years of experience in benefits administration, program management, legal research and analysis, health services, claims administration, financial or operational auditing, policy planning or development, contracts or procurement.
OR Six years of full-time work experience in any field.
OR A bachelor's degree.
Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.

Nice To Haves

Building and Supporting Teams: The ability to combine one's actions and efforts with others to work toward achieving a common goal.
Communicating Effectively: The ability to convey information, ideas, and emotions using structured communication methods that promote understanding and engagement.
Making Accurate Judgments: The ability to assess options, weigh risks, and make sound decisions using available information and logical reasoning.

Responsibilities

Conduct routine customer service duties and provide assistance to the Customer Service administrator and managers.
Take inbound calls in a call center environment to provide assistance and information to plan members, agency representatives, plan providers, third-party companies, and the general public regarding benefits and plans offered.
Respond to inquiries and complaints via email, facsimiles, postal mail, and/or walk-in clients.
Prepare correspondence accordingly and within specific time frames.
Research and analyze complex situations and complaints for problem resolution and/or provide assistance/information to vendors, plan providers, agency representatives, and members.
Consult with Call Center Managers and/or Director as needed.
Generate/review reports periodically to aid in research, validation, or verification of information.
Research and retrieve member records in the imaging system to verify enrollment changes to health and life insurance coverages.
Access the OGB Impact systems to key demographics, health, and life insurance coverage and verify coverage for active and retired State employees.
Prepare documents for imaging.
Provide assistance to member agencies and benefits providers (e.g., insurance companies, drug providers, pharmacists) to clarify and verify plan members' eligibility for services and products.
Process deceased employee/retiree cases, including updating records, notifying relevant entities (e.g., Vital Statistics), and adjusting coverage for surviving family members.
Analyze Medicare data to determine member eligibility and ensure OGB records coordinate with reports from the Centers for Medicare portal.
Perform other duties as assigned.