Health Benefits Specialist
Consider the Health Benefits Specialist a jack of all trades. Whether contributing subject matter expertise to the administration of the group Health Benefit Plan, monitoring processes employed by Third Party Administrators, or helping associates with escalated claims inquiries, our Specialist plays a significant role in our benefits administration.
The Health Benefits Specialist also takes part in designing the plans and handling their administration and regulatory compliance. The Specialist conducts analysis, monitors the quality of available vendors, and shares that information with the Group Benefits department. Furthermore, he or she handles technical tasks related to elevated inquiries, claims appeals and Medicare. Among other important tasks, the Health Benefits Specialist analyzes claims systems and plan performance measures. The Specialist also takes part in project work, which includes monitoring the quality of health plan vendor administration, processing self-insured health plan claims appeals, coordinating Medicare Secondary Payer (MSP) provisions and drafting and interpreting plan documents.
Qualifications we look for
- Bachelor's Degree in a health care related field
- Certification in a field related to the primary responsibilities of this position (i.e. Health Care Administration certification or Certified Employee Benefits Specialist certification)
- Experience working with the administration of health benefit plans, particularly with a claims processing background in a company similar in size to Publix
- Experience working with medical insurance claims processing and adjudication systems
- In-depth knowledge of Medicare Secondary Payer regulations and coordination of benefits payments with Medicare
- Experience with SAP Human Resources Information Systems (HRIS)
- Knowledge of Employee Retirement Income Security Act (ERISA) claims appeals requirements and procedures and Department of Labor regulations
- Knowledge of various laws, rules and regulations, including Consolidated Omnibus Budget Reconciliation Act (COBRA), Women's Health and Cancer Rights Act (WHCRA), Newborns' and Mothers' Health Protection Act (NMHPA), Health Insurance Portability and Accountability Act (HIPAA) Medicare Secondary Payer regulations and Family and Medical Leave Act (FMLA)
- Strong communication skills, both oral and written
- Obvious enthusiasm, initiative and pride in work
How To Apply
Please go to www.publix.jobs/support
to see our current openings. Click "YES" or "NO" to the question, "Are you an active Publix associate?" Then narrow your search by choosing Benefits Administration within the Functional Area selection box.
When you apply, your information will be sent directly to the appropriate hiring manager. If your skills and experience seem to match the qualifications of the position that interests you, you will be contacted for an interview and possibly for testing customized to that position.
If you have any questions about our application process, please call our Employment Office in Lakeland (863-688-7407, ext. 32504) or Atlanta (770-995-0073, ext. 2153).