INTERNAL- Benefits Manager I - Insurance Information Management

*** Only current PEBA employees will be considered for this position. ***
The SC Public Employee Benefit Authority (PEBA) is the administrator and co-trustee of retirement and insurance programs for over half a million active and retired public employees of the State of South Carolina and their dependents.

Under general supervision, this position is responsible for reconciling Insurance Benefits' files with third party carrier files and Center for Medicare and Medicaid Services (CMS) records to identify and resolve discrepancies and update information as necessary, which also includes researching and resolving issues reported by Insurance Benefits' staff, Benefits Administrators or third party administrators and reconciling and retrieving accurate mailing data for retirees and their dependents, as well as updating PEBA's systems.
Job duties include:

• Reconciling records monthly for the Insurance Information Management Unit to ensure enrollment data is timely and accurately updated at the third-party insurance carriers by comparing the enrollment data in Insurance Benefits' system to the data in the insurance carrier's system and research discrepancies identifying problem areas and initiate plans and timeframes to resolve. Updating PEBA Insurance database as necessary.
  
  
• Reconciling records monthly for the Insurance Information Management Unit to ensure certain data in Insurance Benefits' system matches data at CMS by comparing data via Insurance Benefits' Voluntary Data Sharing Agreement (VDSA) with CMS and researches and resolves discrepancies as needed. Reconciling Medicare information received from CMS via PEBA's Medicare Part D Prescription Drug Program by comparing the data with the Insurance Benefits Systems and BlueCross BlueShield (BCBS). Contacting Retirees when necessary to verify Medicare information.
  
  
• Reconciling and retrieving correct mailing data for subscribers and their dependents. Updating PEBA Insurance database, share data with South Carolina Retirement System (SCRS) and forward returned mail when possible. Working closely with Imaging Department to resolve issues.
  
  
• Notifying Insurance Benefits staff, Benefits Administrators and third-party administrative staff of issues by researching and following up as necessary. Forwarding issues to the IT liaison if system changes are necessary. In addition, may work closely with the IT Liaison for testing, enhancements, and changes to the Legacy, EBS or MyBenefits Insurance systems to ensure the successful implementation of enhancements and changes to systems.

A bachelor's degree and relevant program experience in insurance or retirement.

Knowledge of insurance benefits rules, regulations and policies, skill in researching and processing all types of transactions submitted to Insurance Benefits. Ability to communicate effectively. In addition to 13 paid holidays, this position is eligible for comprehensive insurance programs, retirements plans, and a generous paid leave program.