Retirement & Insurance Benefits Specialist
Location
United States
Posted
9 days ago
Salary
$25 - $31 / hour
Job Description
Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.
Retirement & Insurance Benefits Specialist
Department of Employee Trust Funds (ETF)
Responses Due: Until filled
Hours/Week: 40
Duration: More than 12 months
Target Hourly Rate: $25-31/hour
Work Location: Primarily remote; must currently reside in Wisconsin
About ETF
The Department of Employee Trust Funds (ETF) manages retirement, insurance, and other benefit programs for more than 600,000 state and local government employees and retirees within the Wisconsin Retirement System (WRS). ETF is committed to delivering high‑quality, accurate services that support and empower its members.
Position Summary
The Ombudsman Services Specialist supports members by evaluating and resolving concerns related to benefits administered by ETF. This includes health insurance, life insurance, income continuation insurance, disability programs, and Wisconsin Retirement System (WRS) benefits. The role requires independent decision‑making, strong analytical skills, and the ability to interpret complex benefit policies and regulations.
The Specialist frequently serves as an advocate for participants, working with insurance plans, third‑party administrators, and ETF staff to resolve disputes. When a complaint cannot be fully resolved, the Specialist provides guidance on next steps and available options.
Required Candidate Location
- Must currently reside within the state of Wisconsin.
- Position is primarily remote with optional onsite availability.
Key Responsibilities
- Review, investigate, and resolve benefit‑related complaints and inquiries from WRS participants.
- Negotiate changes in benefit interpretations, policies, or practices with insurance plans and administrators.
- Advise participants on grievance, appeals, and dispute‑resolution options when issues remain unresolved.
- Research and interpret applicable state and federal regulations, including Medicare and Medicare supplement rules.
- Prepare written summaries, reports, letters, and educational materials.
- Conduct interviews, gather data, and analyze information relevant to participant concerns.
- Deliver training and educational support on benefit programs when needed.
- Collaborate with internal ETF teams to address systemic issues or recurring participant concerns.
Qualifications
Strong candidates will demonstrate:
- Knowledge of health insurance, life insurance, income continuation insurance, and WRS benefit programs.
- Understanding of state and federal laws, rules, and regulations governing Medicare and Medicare supplement programs.
- Ability to independently prioritize workload and make sound decisions after training.
Additional competencies include:
- Proficient use of computer applications for letters, spreadsheets, and reports.
- Effective written and verbal communication skills.
- Strong human relations skills and professional customer service aptitude.
- Knowledge of public relations and public speaking fundamentals.
- Skill in negotiation, advocacy, and complaint‑resolution techniques.
- Knowledge of interviewing, investigation, research, and data analysis methods.
- Ability to gather, track, and interpret statistical information.
- Understanding of information systems, data processing, and quality improvement methodologies.
- Ability to design and deliver educational materials and training sessions.
- Familiarity with health care delivery systems and benefit plan grievance/appeal processes.
What We’re Looking For
The Ombudsperson Services team seeks a professional with a strong background in insurance and benefits, especially within Wisconsin programs. The ideal candidate will demonstrate sound judgment, clear communication, and a commitment to resolving participant issues with accuracy, fairness, and empathy.
Keyword Search
Wisconsin Retirement System, WRS, ETF, Ombudsman, Benefits Specialist, Health Insurance, Life Insurance, Medicare, Medicare Supplement, Employee Benefits, Public Sector Benefits, Insurance Appeals, Grievance Resolution, Participant Advocacy, Case Resolution, Benefits Analyst, Wisconsin Government Jobs, Remote Wisconsin Jobs
Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides a reasonable range of compensation for this role. In addition, SSO provides a range of benefits for this role.
Applicants must be authorized to work in the U.S. This position is not eligible for work authorization sponsorship (including H-1B sponsorship) by SSO and under the federal laws relating to the F-1 STEM EAD program, this position is not eligible to support a STEM EAD extension application.
All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. Staffing Solutions Organization LLC is an E-Verify participant.
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