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NEOGOV · 4 hours ago

ES Benefit Specialist 3: Insurance Services Lead / Virtual (Internal Only)

United States

Full-time

Remote

Mid, Senior Level

$60K/yr - $81K/yr

4+ years exp

NEOGOV is part of the Employment Security Department of the State of Washington, seeking a Lead Employment Security Benefit Specialist. The role involves leading a team responsible for processing claims and delivering customer service, ensuring compliance and accuracy in operations.

GovTechHuman ResourcesInformation TechnologySoftware

No H1B

Responsibilities

Lead and direct daily work for ES Benefit Specialists and/or ES Benefit Technicians, including assigning and adjusting workloads, monitoring queues, and ensuring timely, accurate service delivery

Provide coaching, mentoring, and performance support; review staff work for accuracy and compliance with laws, regulations, policies, and procedures; and update workflow processes as needed

Guide staff through difficult, complex, or unusual cases and analyze information to support eligibility determinations, premium collection, and benefit adjudication

Serve as a subject matter expert during Customer Care Academy training and respond to inquiries from claimants, employers, and internal partners, offering policy and procedure clarification

Provide senior-level technical expertise on Paid Family & Medical Leave and WA Cares, including complex case review, complaint resolution, and recommendations for process improvements

Deliver expert technical assistance to internal and external customers and ensure individuals needing special assistance receive appropriate support

Perform ES Benefit Specialist 2/Technician duties, including fact-finding, reviewing documentation, adjudicating PFML claims, verifying eligibility, processing case actions, determining benefit amounts, and identifying overpayments or underpayments

Communicate with claimants, employers, healthcare providers, and partner programs to gather information, explain program requirements, and support applications, reporting, and premium payments

Participate in trainings, unit meetings, all-staff meetings, and public outreach events such as webinars and informational sessions

Qualification

Paid Family Medical LeaveRegulatory KnowledgeAnalytical SkillsTechnical AssistanceData AnalysisCommunication SkillsProblem-SolvingTask ManagementAttention to DetailAdaptability

Required

Six (6) years of equivalent education/experience

One (1) year as an ES Benefit Specialist 2

One (1) year of experience equivalent to the ES Benefits Specialist 2 with another state that administers insurance benefits programs

Associate's Degree in health or social science, public administration or a related field AND Four (4) years of the required experience below

Bachelor's Degree in a health or social science, public administration or a related field AND Two (2) years of the required experience below

Master's Degree in a health or social science, public administration or a related field AND One (1) year of the required experience below

A minimum of 12 semesters or 18 quarter hours of college-level accounting

The ability to take action to learn and grow

The ability to take action to meet the needs of others

Proficiency in explaining complex regulations clearly

Expertise in analyzing claim documentation for accuracy

Proficiency in navigating complex claims and issues

Technical proficiency to understand system functionality, attention to detail to identify errors, problem-solving to troubleshoot issues, data analysis to verify accuracy, and communication skills to report findings effectively

Ability to perform various tasks as needed including those of lower-level positions

Must be able to pass an Unemployment Insurance (UI) and Paid Family Medical and 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 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.

Leave Sharing

Parental Leave

Family and Medical Leave Act (FMLA)

Leave Without Pay