BENEFITS CLAIMS SUPVSR

Number of positions: 1 (additional vacancies possible pending budget approval)

Starting salary: $78,768

About the role

Under direction, oversees and manages the resolution of claims deemed ineligible by insurance carriers, and performs related duties as required.

Responsibilities

• Assigns benefits claims to staff and monitors their resolution
• Reviews claims reports completed by staff for completeness and appropriateness of recommendations
• Trains staff on new and revised claims-related policies and procedures
• Interprets benefits claims policies to staff, claimants, and service providers
• Researches complex benefits claims by reviewing claims and compiling medical histories, researching medical information, and analyzing the current and future cost implications
• Acts as liaison to various parties involved in the claims resolution process, including contracted service providers, Medical Advisors, and the Benefits Committee, providing recommendations for the resolution of claims
• Oversees the City's Health plan enrollment and eligibility appeals process and claims disputes
• Drafts correspondence in response to inquiries regarding eligibility of benefits
• Reviews requests for alternative coverage for individuals who missed enrollment deadlines
• Processes applications for continuation of coverage for disabled and military dependents
• Coordinates work efforts with attorneys on subrogation cases involving the recovery of benefits costs from third parties
• Interprets the City's benefits policies to staff, contracted agencies, and labor unions
• Participates in establishing and revising benefits policies and negotiating prices with contracted service providers and insurers
• Prepares status reports of pending claims cases
• Testifies in court on findings of complex claims cases, as required
• Attends vendor meetings and reviews reports
• Manages the HIPSS HCSC ASO Disclosure Notification process and the Telligen Qualitrac Portal Form
• Serves as the City's lead in coordinating all open enrollment annual activities, including but not limited to: OE and New Hire Guide, Postcard Announcements, Legal Notices, Updates to Employee Benefits Portal, Posters, Bulletins, and annual Benefits Fairs

Requirements

Nine (9) years of work experience in claims management, of which two (2) years are in a supervisory role related to the responsibilities of the position OR

Graduation from an accredited college with an Associate’s degree in Business Administration or a directly related field, PLUS seven (7) years of work experience in claims management, of which two (2) years are in a supervisory role related to the responsibilities of the position OR

Graduation from an accredited college or university with a Bachelor's degree in Business Administration or a directly related field, PLUS five (5) years of work experience in claims management, of which two (2) years are in a supervisory role related to the responsibilities of the position OR

Graduation from an accredited college or university with a Master’s degree or higher in Business Administration or a directly related field, PLUS four (4) years of work experience in claims management, of which two (2) years are in a supervisory role related to the responsibilities of the position.

Schedule

• Location: 2 N LaSalle
• Days: Monday – Friday
• Hours: 8:30 AM – 4:30 PM

Benefits

For information on employee benefits, visit the City of Chicago Benefits Office website.