The State of Washington is seeking an ES Benefits Specialist 2 (In-Training) to provide excellent service to customers while processing and adjudicating Paid Family and Medical Leave claims. The role involves reviewing eligibility documents, ensuring compliance, and delivering customer care through various communication channels.
Responsibilities
- Processing and adjudicating routine and complex Paid Family and Medical Leave claims
- Reviewing documents such as wage and hour information, identity verification and medical certifications to determine eligibility for Paid Family and Medical Leave benefits
- Fact finding for additional documentation and supporting evidence
- Processing weekly claims and identifying need for corrections or adjustments to ensure timely and accurate benefit payments
- Processing and adjudicating both monetary and non-monetary benefit redeterminations
- Providing excellent customer service to a high volume of customer communications via phones, secure messaging and emails
- Initiate and respond to routine and complex correspondence and inquiries from claimants and/or their representatives, employers, other public programs and healthcare providers
Skills
- Five (5) years of equivalent education/experience
- One (1) year as an ES Benefit Specialist 1
- One (1) year of experience equivalent to the ES Benefits Specialist 1 with another state that administers insurance benefits programs
- Associate's Degree in a health or social science, public administration or a related field and three (3) years of the required experience below
- Bachelor's Degree in a health or social science, public administration or a related field and one (1) year of the required experience below
- Skill in processing and adjudicating claims
- Ability to document and verify benefit requests
- Ability to gather facts and advise on rights and responsibilities
- Ability to make decisions based on laws and policies
- Ability to explain program requirements and services
- Skill in resolving issues and communicating outcomes
- Ability to perform various tasks as needed including those of lower-level positions
- The ability to take action to learn and grow
- The ability to take action to meet the needs of others
- Must be able to pass Unemployment Insurance (UI) & Paid Family and Medical Leave (PFML) claim and fraud check
Benefits
- Employees and their families are covered by medical (including vision), dental and basic life insurance.
- Staff are eligible to enroll each year in a medical flexible spending account which enables them to use tax-deferred dollars toward their health care expenses.
- Employees are also covered by basic life and long-term disability insurance, with the option to purchase additional coverage amounts.
- Dependent care assistance allows the employee to save pre-tax dollars for a child or elder care expenses.
- Other insurance coverage for auto, boat, home, and renter insurance is available through payroll deduction.
- The Washington State Employee Assistance Program promotes the health and well-being of employees.
- State Employees are members of the Washington Public Employees' Retirement System (PERS).
- Employees also have the ability to participate in the Deferred Compensation Program (DCP).
- All state employees are covered by the federal Social Security and Medicare systems.
- If you are employed by a government or not-for-profit organization, and meet the qualifying criteria, you may be eligible to receive student loan forgiveness under the Public Service Loan Forgiveness Program.
- Full-time and part-time employees are entitled to paid holidays and one paid personal holiday per calendar year.
- Full-time employees earn eight hours of sick leave per month.
- Full-time employees accrue vacation leave at the rates specified in WAC 357-31-165(1) or the applicable collective bargaining agreement (CBA).
- Washington State supports members of the armed forces with 21 days paid military leave per year.
- Most employees whose family member or household member dies, or for loss of pregnancy, are entitled to five (5) days of paid bereavement leave.
Company Overview
Washington state public employees help to create a working Washington built on education and innovation, where all Washingtonians thrive. It was founded in 1889, and is headquartered in Olympia, Washington, USA, with a workforce of 10001+ employees. Its website is http://access.wa.gov/.
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