Risk Management Specialist

Oxnard School District Oxnard , CA 93030

Posted 2 weeks ago

Description Benefits Supplemental Questions

SUMMARY OF DUTIES

Under the direction of the Risk Manager, performs a variety of technical duties related to the District's comprehensive health benefits, workers' compensation and liability programs; serves as the District's resource person in the area of employee benefits programs including insurance, enrollment, eligibility, billing and record-keeping functions; provides information and assistance to employees regarding health benefits and workers' compensation coverage, claims and related procedures; assists in the coordination, processing, and resolution of workers' compensation claims; and performs a variety of duties relative to assigned area of responsibility.

SUPERVISION RECEIVED AND EXERCISED

  • Receives supervision from the Risk Manager.

  • May provide work direction to support staff.

  • Positions in this classification have no formal supervisory responsibilities.

Examples of Duties:ESSENTIAL DUTIES

  • Processes Human Resources benefit status changes; determines benefits eligibility and premium contributions according to bargaining unit agreements, District policy, insurance company or trust rules and regulations, and state and federal laws;

  • Enroll, add and delete employees in health benefit plans, makes dependent and other status changes to benefit coverage; calculates cost associated with benefit changes and creates summary reports of changes and associated cost; reviews enrollment and change forms and other documents for accuracy and forwards to appropriate carriers;

  • Assists beneficiaries with life insurance claims and forwards to insurance carrier;

  • Assists and conducts employee health benefits orientation for the purpose of informing employees about benefit plans, enrollment options, and policies and procedures for filing claims;

  • Provides routine and specialized employee benefits information and responds to inquiries from employees, retirees, insurance companies and agents regarding benefits coverage, enrollment options eligibility, claims procedures, work-related injuries, medical leave, liability/property claims and disability status;

  • Audits and reconciles the monthly billing and premiums; determines, requests and remits premium payments for health benefits programs and life insurance plan;

  • Organizes and coordinates District health benefit fairs and annual open enrollment;

  • Serves as District liaison to insurance company and benefits trust administrators in resolving claim problems, issues, and contract compliance;

  • Manages and balances various benefit accounts related to health benefits; calculates pro-rated premiums for part time employees eligible for benefits;

  • Verifies benefits coverage as requested by health care providers as well as coordination of benefits with other businesses;

  • Compiles statistical data and reports required in the administration of the various fringe benefit programs; monitors carrier compliance with contract provisions and District policies; tracks employee eligibility regarding leaves of absence;

  • Assist injured employee with initiating and filing Workers' Compensation claim; monitor and keeps employee current concerning claim status, progress; assists in facilitating the return-to-work program; acts as a liaison between claims administrator, associated firms and the District in managing claims; gathers information, completes, maintains and processes a variety of forms and reports related to workers' compensation;

  • Receives and processes salary continuation payments for disabled employees; audits open workers compensation claims; verifies industrial accident leave on employee timesheets and advises the payroll department how to charge time appropriately;

  • Accurately processes Workers' Compensations forms within twenty-four hours of knowledge using established procedures; forwards completed reports to claims administrator and affected job sites;

  • Audits county reports for District safety credit expenditures; researches files for purchase orders, prepares and submits claims for reimbursement to Ventura County School Self-Funding Authority;

  • Independently prepares and responds to correspondence and memoranda pertaining to various employee benefits and worker's compensation related problems, issues, and concerns;

  • Develop, prepare and disseminate forms for the District's health benefits and workers' compensation programs;

  • Prepare and distributes a variety of reports including workers' compensation carrier reports, CAL/OSHA, data summaries, and related reports; completes annual Department of Labor Report as required.

  • Establishes and maintains employee benefits and workers' compensation files for all eligible employees;

  • Compiles information and completes state benefit surveys.

Other Related Duties

  • Attends and participates in Board meetings of the Benefits Trust as needed;

  • Assists in receiving calls, logging and mailing employee workers' compensation claim forms for reported injuries; receives completed employee claims and forwards documents to claims administrator as needed;

  • Assist in the updating and creation of department forms related to employee benefits and workers' compensation;

  • Updates Risk Management department information on District webpage as needed;

  • Performs related duties and responsibilities as required.

KNOWLEDGE, ABILITIES, AND TRAITS

Knowledge of:

  • Applicable rules, regulations, and policies of the District and health care providers pertaining to employee benefit coverage;

  • Applicable Federal, State and local laws, codes and regulations;

  • Principles of benefit program administration, including enrollment, eligibility, and claims processing;

  • Practices and procedures of workers' compensation claims processing and resolution, including support of litigation.

  • Techniques for balancing and reconciling claims, payments, and deductions for benefits;

  • Laws, rules and regulations related to employee benefits and Workers' Compensation;

  • COBRA Regulations and Family Medical Leave Act application and regulations.

  • Principles and practices of record keeping;

  • Computer applications and systems relevant to benefits administration

  • Correct English usage, grammar, spelling, punctuation, and vocabulary;

  • Good public relations techniques;

  • Interpersonal skills using tact, patience, and courtesy;

  • Principles of business letter writing and basic report preparation.

Ability to:

  • Interpret and explain the District's contract provisions, rules, regulations, and policies pertaining to employee benefit coverage and workers' compensation;

  • Understand and accurately interpret and apply technical information, laws, rules, regulations, and other guidelines pertaining to benefits administration and workers' compensation.

  • Compile information and data and prepare reports;

  • Analyze and solve complex and administrative problems and exercise initiative and sound judgment in developing effective and efficient solutions;

  • Maintain confidentiality of privileged information obtained in the course of work;

  • Work independently within established time lines and with minimal direction;

  • Compose and prepare correspondence and reports independently;

  • Operate a variety of office machines and equipment such as a personal computer and, applicable hardware and software, copiers, printers, scanners, calculators, and fax machines;

  • Accurately and efficiently perform alphanumeric and 10-key calculator;

  • Provide information and assistance to District staff, Board members, business representatives, and the general public in a helpful, courteous and timely manner;

  • Communicate effectively, both orally and in writing;

  • Establish and maintain cooperative working relationships with those contacted in the course of work;

  • Understand and follow oral and written directions;

  • Maintain regular and consistent attendance.

Traits:

  • Diligently attends to details and quality;

  • Easily adapts to situations and changes;

  • Effectively manages one's own time, priorities, and resources;

  • Is trustworthy and responsible for his/her actions;

  • Logically grasps and thinks through issues and problems;

  • Remains steady under pressure;

  • Stays focused and has good work ethic;

  • Strives to meet customers' needs.

Employment Standards:EMPLOYMENT STANDARDS

Education: Graduation from high school supplemented by college-level coursework in business administration, human resources, accounting, benefits, insurance or a closely related field.

Experience: Two years of experience in benefits administration, workers' compensation, or a closely related area of human resources.

Physical Requirements:
Employees in this classification stand, walk, sit, stoop/bend, reach overhead, lift and carry up to 20 lbs., use fingers repetitively, use both hands simultaneously, speak clearly, hear normal conversation, and see small details.

WORK ENVIRONMENT: Employees in this classification work primarily inside an office environment, with frequent interruptions, with changing priorities and short deadlines, and have direct contact with other employees and the public.

APPOINTMENT: In accordance with Education Code Section 45301, an employee appointed to this class must serve a probationary period of six (6) months during which time an employee must demonstrate at least an overall satisfactory performance in order to attain permanent status in the classified service.

Salary Range: 23.0

Supplemental Information:For an overview of the Classified Employment Process including information on application screening, testing, health and welfare benefits, and advanced salary step placement, please click here: Classified Employment Procedure.

Please refer to the "Employment Standards" section of this bulletin to make sure you meet all requirements before applying. Applications for employment are accepted online only.

Class specifications are intended to present a descriptive list of the range of duties performed by employees in the class. Specifications are not intended to reflect all duties performed within the job.


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Risk Management Specialist

Oxnard School District