Why This Employee Benefits Investigator (Senior Advisor Health Investigations) Job Matters
Join the <strong class="text-gray-900">Employee Benefits Security Administration</strong> and make an impact.
Employee Benefits Investigator (Senior Advisor Health Investigations) Job Overview
Specialized Experience is the experience that equipped the applicant with the particular knowledge, skills, and abilities (KSA's) to perform the duties of the position successfully, and that is typically in or related to the position to be filled. To be creditable, specialized experience must have been equivalent to at least the next lower grade level. Applicants must have 52 weeks of specialized experience equivalent to at least the next lower grade level, GS-13 in the Federal Service. Qualifying specialized experience for GS-14 includes: Experience with programs, priorities and the civil laws administered by Federal and State agencies which impact health benefit plan activities and health coverage. Experience with the health benefit industry, benefit claims processing, investigative methodology, auditing and accounting systems. Experience with regulatory requirements and sub-regulatory guidance of Employee Retirement Income Security Act (ERISA) including the group health plan requirements under part 7 as amended by HIPAA, MHPA, MHPAEA, WHRCA, Newborn's Act, GINA, Michelle's Law, CHIPRA and the Affordable Care Act. Experience analyzing and measuring the effectiveness and efficiency of the health enforcement programs.