LEIGH A. BERNING

Essential Functions:

• Responsible for balancing the TRS Annuitant Periodic and Non-Periodic payroll records, preparing payroll vouchers, obtaining proper signatures, and approving file transfers.
• Responsible for the annual Annuitant Periodic and Non-Periodic Voucher Schedules. Collaborate with the TRS Accounting Department, Office of the Illinois Comptroller, and Scrum teams to validate the dates prior to loading into the TRS system.
• Responsible for review and approval of daily TRIP payroll files including the annual TRIP Benefit Choice Enrollment file and the annual TRAIL MAPD Enrollment file sent from the CMS third-party administrator. Initiate action with CMS or CMS' third-party administrator to correct insurance issues resulting from enrollment or premium discrepancies.
• Verify Federal and State tax withholding amounts in the TRS system. Obtain annual IRS tax tables and collaborate with the TRS IT Department to test the new data in the TRS system.
• Responsible for inputting member and dependent Medicare data into the TRS system and the CMS third-party administrator’s system. Verify the data after entry and adjust the insurance premium/s accordingly. Seek corrective action when insurance events do not populate appropriately in the CMS third-party administrator’s system.
• Responsible for the monthly State Employees Group Insurance File process and the deduction of the appropriate premiums. Collaborate with state agency representatives to obtain state member records.
• Calculate, edit, and correct TRS member accounts according to adjustment made during the monthly annuity returns process. Collaborate with the Office of the Illinois Comptroller to ensure both systems are synchronized.
• Produce system discrepancy (SCRUM) reports comparing data between the CMS third-party administrator’s system and the TRS system. Responsible for research and corrective action including insurance and payroll adjustments.
• Review and reconcile payroll discrepancies between the Teacher’s Retirement System and the Office of the Illinois Comptroller including verification and transference of the monthly match file. Edit and document correction action taken on the member record and complete the necessary forms with the Office of the Illinois Comptroller. Document modifications for internal and external audits.
• Coordinate and complete the year-end payroll processing schedule with the TRS IT Department and the Office of the Illinois Comptroller.
• Review, calculate and complete necessary forms for final adjustments, 1099R corrections, Social Security Number changes. Review, calculate, and complete the annual 869 and 1375 ad-hoc increases. Submit a request to run the process which produces the applicable letters. Coordinate with the Accounting department and the Benefits department to add the appropriate adjustment to the member’s record.
• When needed, represent the Payroll and Insurance Manager at meetings and other events, serving as the subject matter expert on insurance and payroll related issues.
• Test new features and enhancements within the TRS systems, the CMS Membership system, and the CMS third-party administrator system. Provide input on success and functionalities that need more technical intervention to management. Serve as a liaison between other staff and the Information Technology Department regarding computer application and design.
• Provide guidance and training to lower-level Payroll and Insurance Analysts on insurance and payroll issues. Verify written correspondence and assist staff with resolution of discrepancies within the CMS third-party administrator system.
• Input the Annual Payroll dates into the CMS Membership system and the TRS system.
• Assist the Payroll and Insurance Manager in the development and maintenance of training materials and insurance benefit publications. Provide training and prepares for onsite presentations as needed.
• Assist the Payroll and Insurance Manager with obtaining information and documentation for auditing purposes.

• Responsible for the flow of health insurance for the employees of Memorial Medical Center. Duties included quality assurance checks, review and update of suspended claims, handling provider refunds and processing claims. Ability to function in a production oriented environment. Assist member services with inquiries. Possess knowledge of both Health Maintenance Organizations (HMO) and Third Party Health Plans.
• Prohealth Services

• Processed health insurance claims for the Association sponsored Employees Trust. Developed skills on a Wang computer system.

• Responsible for processing health insurance claims for members who subscribed to Health Maintenance Organization (HMO). Accountable for establishing membership, determining benefits, gathering information by written and telephone requests in order to adjudicate claims by means of direct data entry through CRT terminals. Also assisted in resolving members' questions/problems by verbal and written communication.

• Processed medical group claims for the State of Illinois including: billing compilation, the application of ICD-9 and CPT codes concerning the adjudication of claims.