Health Insurance Analyst

Position Summary

This position is responsible for processing all aspects of members' health insurance, including determining eligibility, enrollment, and status, while applying intermediate knowledge and independent judgment to resolve moderately complex issues and enhance departmental performance.

Essential Job Duties

• Analyze and process health insurance for retirees by determining eligibility, reviewing applications, and processing member enrollment
• Oversee preparation and analysis of the Consolidated Omnibus Budget Reconciliation Act system, including eligibility, enrollment, rebates, and monthly reporting
• Manage the outside rebate process by determining eligibility, reviewing information and reports, and processing rebates to eligible employees
• Collaborate with the Health Insurance Operations team to complete monthly payroll review and examine fellow analysts' work for accuracy
• Communicate with the Member Services Unit regarding health insurance information and educate them to assist members with questions and concerns
• Respond to escalated concerns as necessary
• Process Death Master reviews to ensure accuracy of data
• Maintain subject matter expertise of government health insurance programs including Medicare Parts A, B, and D
• Review and update existing procedures and documents as needed
• Additional duties as assigned

Qualifications

• High school diploma or equivalent with 3-5 years of experience
• Bachelor's degree preferred

Knowledge, Skills, and Abilities

• Strong written and verbal communication skills for interacting with members and internal teams
• Demonstrated analytical and organizational skills with attention to detail for processing health insurance applications and data
• Strong problem solving and time management skills to resolve moderately complex issues and meet deadlines
• Ability to work well in a team and build productive working relationships
• Proficient knowledge of Microsoft Office, including Microsoft Word and Excel for preparing reports and documentation

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job.

• Likely sit for long periods of time with some standing and repetitive physical activity
• May occasionally lift and/or move up to 10 pounds

Work Environment

This job is performed in an indoor office environment and involves regular use of computers and other standard office equipment. Work outside the usual schedule may be required, including evening meetings, weekends, or limited travel.

Supervisory Responsibility

• No direct reports

Disclaimer: This job description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees may be required to follow other job-related instructions and to perform other job-related duties as requested, subject to all applicable state and federal laws. Management reserves the right to revise or change job descriptions, job duties, functions and requirements as the need arises.

This job description does not constitute a written or implied contract of employment.

CTPF is an Equal Opportunity Employer. CTPF does not discriminate due to race, color, creed, religion, sex, sexual orientation, gender and/or gender identity or expression, marital or parental status, national origin, ethnicity, citizenship status, veteran or military status, age, disability, unemployment status, or any other legally protected basis. Qualified candidates of diverse backgrounds are encouraged to apply for any vacant positions.