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Benefits Technician (job code 1209)-San Francisco Health Service System

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Job Description - Benefits Technician (job code 1209)-San Francisco Health Service System

Company Description

This is a Position- Based Test conducted in accordance with CSC Rule 111A. Learn more about the City’s hiring process here: https://careers.sf.gov/knowledge/process/



Application Opening: Monday, May 19, 2025

Application Deadline: The application portal will be open until Monday, June 2, 2025 11:59 p.m. 

The portal will close at 12:00 a.m. on Tuesday, June 3, 2025, and applications will no longer be accepted.

The San Francisco Health Service System (SFHSS) was established in 1937 to provide medical care for municipal employees. SFHSS is responsible for all health benefits administration, including medical, dental, vision, flexible spending accounts (FSA), and a wide array of voluntary benefits for the employees, retirees, and covered dependents of the City and County of San Francisco (CCSF), San Francisco Unified School District, City College of San Francisco, and Superior Court of San Francisco.

SFHSS is dedicated to ensuring quality and sustainable benefits that enhance the whole-person health and well-being of our members and their families throughout their lifecycles.

Job Description

Under immediate supervision, performs technical and clerical work in employee benefits for the City's Health Service System, Retirement System, or Workers' Compensation Program and performs related duties as required. Essential functions include: providing support services to analysts or adjusters in processing claims and benefit entitlements; providing general information to City employees regarding benefits; communicating with employees and representatives from various departments and outside agencies; researching and reconciling records and accounts; making adjustments and performing database maintenance; reviewing, completing and processing a variety of membership forms and medical claims; performing various calculations; completing standard form letters; and maintaining reports, logs and records.

Class 1209 Benefits Technician is the entry-level class of the Employee Benefits series performing technical and administrative support and research.

Essential duties

According to Civil Service Commission Rule 109, the duties specified below are representative of the range of duties assigned to this job code/class and are not intended to be an inclusive list.

1. Provides support services to analysts or adjuster in processing claims and benefit entitlements.

2. Provides general information to City employees regarding retirement benefits, health and dental benefits, or worker's compensation benefits.

3. Researches records and accounts for prior membership, premium history, account discrepancies, requested information, buybacks, withdrawal status, payment history, prior claims, overpayments, underpayments, injury information, and adjustments in database.

4. Makes adjustments, and creates, updates, inputs, and maintains information in the computer software files or in the database.

5. Reviews, completes, and processes a variety of membership forms, medical claims, and medical only (worker's compensation) claims.

6. Conducts research on claims to determine appropriate rates to use for payment and refers claims needing further attention to an analyst or claim examiner.

7. Performs various calculations to support the determination of retirement, health services, or worker's compensation benefits.

8. Communicates with employees, dependents, human resources, and payroll personnel within citywide departments, representatives from outside agencies, medical practitioners, lawyers, and other professionals.

9. Responds to routine vendor and claimant tracer inquires on unpaid medical invoices and medical only claims.

10. Completes standard form letters, and maintains reports, logs, and records.

11. Acts as a verifier to check work performed by another technician at the end of the day.

12. Performs related duties and responsibilities as assigned.

Knowledge, skills, and Abilities

Knowledge of: basic technical knowledge of employee benefits programs such as pension plans, worker's compensation, labor code, and medical terminology.

Ability or Skill to: perform accurate calculations following a prescribed format; problem solve to identify problems and make routine adjustments; research to gather meaningful information and perform routine analysis; speak and write in a clear, concise, and understandable manner to answer benefits questions; and establish and maintain effective working relationships, and assist in a polite, courteous manner.

Please note that incumbents in this classification may be required to perform duties as listed in the class specification, which can be found on DHR’s website: 1209-Benefits Technician | City and County of San Francisco

Qualifications

Education:

Completion of two (2) years college-level course work

Substitution:

Verifiable clerical or technical experience administering employee benefits programs including: researching records, claims adjudication, database maintenance, reviewing forms, performing calculations, and responding to general inquiries may be substituted for the required education on a year-for-year basis. Thirty (30) semester units/forty-five (45) quarter units equal one year of experience.

Desirable Qualifications:

The stated desirable qualifications may be considered at the end of the selection process when candidates are referred for hiring.



•Knowledge of health plan administration

•Strong writing skills

•Strong Microsoft Word and Excel skills

•Ability to understand and apply rules and regulations



Verification of Education and Experience:

Applicants may be required to submit verification of qualifying education and experience at any point during the recruitment and selection process. If education verification is required, information on how to verify education requirements, including verifying foreign education credits or degree equivalency,

can be found at https://sfdhr.org/how-verify-education-requirements.

Please review our articles on Employment Application and Minimum Qualifications and Verification of Experience and/or Education for further information.

Applicants will receive a confirmation email from [email protected] that their online application has been received in response to every announcement for which they file. Applicants should retain this confirmation email for their records. Failure to receive this email means that the online application was not submitted or received.



Note: Falsifying one’s education, training, or work experience or attempted deception on the application may result in disqualification for this and future job opportunities with the City and County of San Francisco.

Additional Information

Selection Procedure:

After application submission, candidates deemed qualified must complete all subsequent steps to advance in this selection process, which includes the following:



Minimum Qualification Supplemental Questionnaire (MQSQ): Candidates will be required to complete a MQSQ as part of the employment application at a later time. This MQSQ is designed to obtain specific information regarding an applicant's experience in relation to the Minimum Qualifications (MQ) for this position. The MQSQ will be used to evaluate if the applicant possesses the required minimum qualifications.



Supplemental Questionnaire Evaluation (Weight: 100%)

Candidates who meet the minimum qualifications will be sent a Supplemental Questionnaire. The Supplemental Questionnaire is designed to measure the knowledge, skills and abilities required for this position.  All candidates’ responses to the Supplemental Questionnaire are subject to verification. All relevant experience, education and/or training must be included in the responses in order to be reviewed in the rating process.

A passing score on the Supplemental Questionnaire must be achieved in order to be placed/ranked on the eligible list.

Eligible List/Score Report:

A confidential eligible list of applicant names that have passed the civil service examination process will be created, and used for certification purposes only. An examination score report will be established, so applicants can view the ranks, final scores and number of eligible candidates. Applicant information, including names of applicants on the eligible list, shall not be made public unless required by law. However, an eligible list shall be made available for public inspection, upon request, once the eligible list is exhausted or expired and referrals resolved. The eligible list/score report resulting from this civil service examination process is subject to change after adoption (e.g., as a result of appeals), as directed by the Human Resources Director or the Civil Service Commission.



The duration of the eligible list resulting from this examination process will be 6 months, and may be extended with the approval of the Human Resources Director.



To find Departments which use this classification, please see the city’s Position Counts by Job Codes and Departments. Position-Counts-by-Job-Codes-and-Department-FY-2023-24.pdf



Terms of Announcement and Appeal Rights

Terms of Announcement and Appeal Rights: Applicants must be guided solely by the provisions of this announcement, including requirements, time periods and other particulars, except when superseded by federal, state or local laws, rules or regulations. [Note: The correction of clerical errors in an announcement may be posted on the City's Career website at https://careers.sf.gov/.] The terms of this announcement may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department of Human Resources, 1 S Van Ness Avenue, 4th Floor, San Francisco, CA 94103-5413 by close of business on the 5th business day following the issuance date of this examination announcement. Information concerning other Civil Service Commission Rules involving announcements, applications and examination policies, including applicant appeal rights, can be found on the Civil Service Commission website at https://sf.gov/departments/civil-service-commission.

Additional Information Regarding Employment with the City and County of San Francisco:



Additional Information Regarding Employment with the City and County of San Francisco

If you have any questions, you may contact Lauren Rowe at [email protected]  

Recruitment ID:  RTF0157104-01100957, Eligible list 157105

The City and County of San Francisco encourages women, minorities and persons with disabilities to apply. Applicants will be considered regardless of their sex, race, age, religion, color, national origin, ancestry, physical disability, mental disability, medical condition (associated with cancer, a history of cancer, or genetic characteristics), HIV/AIDS status, genetic information, marital status, sexual orientation, gender, gender identity, gender expression, military and veteran status, or other protected category under the law.

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