Job Description

　　Office Support Specialist I - Benefit Specialist

　　About the Agency

　　The Group Insurance Commission (GIC) seeks to hire an Office Support Specialist - Medicare Benefit Specialist (Office Support Specialist I). The GIC provides high-value health insurance and other benefits to state employees, retirees, and their survivors and dependents. The GIC also covers housing and redevelopment authorities as well as certain municipalities that elect to join the GIC. The agency works with vendors selected through competitive bidding to offer cost-effective benefits produced with careful plan design and rigorous ongoing management. The agency's performance goals are to provide affordable, high quality benefits and, as the largest employer purchaser of health insurance in the Commonwealth, to use that position to drive improvements in the health care system. The GIC's FY2022 appropriation is $2.1 billion and there are currently over 460,000 people covered by the GIC.

　　The GIC administers the Commonwealth's health, life, long term disability, flexible spending accounts, dental and vision insurance programs for some 460,000 state employees, retirees, and their dependents. These responsibilities are conducted pursuant to the authority vested in the agency by MGL Chapter 32A and 32B.

　　Position Summary

　　This position is part of the Operations Division which administers the Commonwealth's health, life, long term disability, dental and vision insurance programs. This employee determines eligibility and processes insurance coverage documents ensuring that documents are accurate, complete and in compliance with eligibility rules. This job will be primarily telework and the employee will serve as a customer service representative answering a high volume of phone calls concerning GIC benefits and manage those external interactions through GIC's Customer Relationship Management (CRM) system. Employee must be detail oriented, have the ability to multitask, meet deadlines and provide verbal and written communication effectively. The ideal candidate would be someone with employee benefit program experience, and especially experience working with Medicare programs.

　　Duties and Responsibilities

　　Serve as the front line to GIC members and coordinators, primarily on the phone, who require assistance with GIC-sponsored life insurance, Medicare/retirement benefits, and dental benefits.Responds to inquiries by providing GIC benefit information through telephone, email, and live chat.Determines insurance eligibility for GIC benefits in accordance with MGL Chapter 32A and 32B and GIC's Rules and Regulations.Collects complete GIC benefit enrollment information from employees, retirees and dependents, including documents and enrollment forms, and processes insurance coverage changes in GIC's eligibility and CRM system.Coordinate monthly insurance deductions with payroll/pension systems..Calculate enrollee's premium and determines necessary billing/refunds.Contact members in writing, by phone or email on prescription drug eligibility and enrollment issues that need to be resolved.Responds to written and phone inquiries concerning GIC benefits.Work with the Centers for Medicare and Medicaid (CMS) eligibility system to verify Medicare eligibility.Maintain general knowledge of Federal government's rules of eligibility for Medicare coverage and enrollment guidelines.Work hours are 8:45 am to 5:00 pm.

　　Preferred Qualifications

　　Familiarity with employee benefit programs.Ability to gather information, make decisions, and make appropriate changes involving GIC enrollees.Ability to research information and draw conclusions and make recommendations.Experience with Case Relationship Management Systems, preferably Salesforce.Ability to communicate effectively both verbally and in writing.Possess good organizational skills.Knowledge of general office procedures and practices.Ability to operate general office equipment including computers, copiers, fax machines and scanning equipment.Ability to meet deadlines.Ability to analyze and determine the applicability of data, to draw conclusions and make appropriate recommendations.Ability to exercise discretion in handling confidential information.Ability to establish and maintain harmonious working relationships with others.Ability to work independently and in teams.Experience with Microsoft Office Suite, emphasis with Excel and PowerPointCandidate must speak fluent English.Bilingual Spanish/English candidates desired

　　Qualifications

　　First consideration will be given to those applicants that apply within the first 14 days.

　　Office Support Specialist I:

　　Applicants must have at least (A) two years of full-time, or equivalent part-time, experience in administrative work experience or (B) any equivalent combination of the required experience and the substitutions below:

　　Substitutions:

　　I. An Associate's or higher degree with a major in business administration, business management or public administration may be substituted for the required experience.

　　II. An Associate's or higher degree with a major other than in business administration, business management or public administration may be substituted for a maximum of one year of the required experience.

　　Education toward such a degree will be prorated on the basis of the proportion of the requirements actually completed.

　　Educational substitutions will only be permitted for a maximum of two years of the required experience.

　　An Equal Opportunity / Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.