Benefit Specialist

Description

The Benefits Specialist is a key member of the HR department, primarily responsible for administering and managing employee benefit programs, including health insurance, retirement plans, life insurance, and other employee perks. This role ensures employees understand their options and can access benefits accurately while staying compliant with relevant laws. Acting as the primary point of contact for employees regarding benefit questions and enrollment changes, the Specialist supports the administration, reconciliation, and auditing of employee benefit plans.

Additionally, this role ensures accurate billing, eligibility tracking, and vendor invoicing while identifying discrepancies and recovering overpayments through vendor credits. The Benefits Specialist will also manage benefit administration for employees on leave, including FMLA, unpaid leave, and other leave-of-absence situations.

Requirements

Key Responsibilities

Benefits Administration & Employee Support

• Manage the daily activity of Global Benefit Plans for all team members, including international teams (covers 401(k), 409a, Medical, Dental, Vision, Disability, Life Insurance plans, Health Savings Accounts, Employee Assistance Programs, and COBRA).
• Inform and advise employees on benefit plan details regarding eligibility, coverage, and provisions.
• Drive and manage the annual open enrollment process.
• Act as a resource and subject matter expert regarding exclusions, eligibility, and other information related to benefits programs.
• Troubleshoot and assist Team Members in the HRIS system (Paylocity).
• Maintain and disseminate employee health plan provider directories and attend regular Network Management meetings as a representative for the health plan.
• Collaborate with the department manager to develop and present training sessions for benefits and leave programs for regular staff, managers, and supervisory employees.
• Coach management on benefit administration policies and procedures.
• Leave of Absence (LOA) & Workers' Compensation
• Effectively manage and interpret FMLA, LOA, and Workers’ Compensation processes, including claims monitoring and ADA implications as they relate to leaves of absence and disabilities.
• Administer the company’s workers’ compensation program, including receiving initial accident reports and ensuring all work-related injuries are treated promptly.
• Guide management in understanding FMLA, medical leave, personal leave, and workers’ compensation requests as they are submitted, ensuring proper documentation.

Benefits Reconciliation & Auditing

• Review and reconcile monthly benefit invoices from medical, dental, vision, life insurance, disability, and voluntary plans.
• Analyze invoices to ensure charges align with employee enrollments and eligibility records.
• Identify billing discrepancies, overcharges, and enrollment errors.
• Research and resolve invoice variances in a timely manner and obtain credits and refunds for overpayments and billing errors.
• Maintain an invoice tracking system to monitor receipt, approval, payment status, and outstanding issues.
• Ensure benefit invoices are submitted for payment accurately and on time, maintaining documentation supporting reconciliations, adjustments, and vendor communications.
• Reconcile Health Savings Account (HSA), Healthcare Flexible Spending Account (FSA), and Dependent Care FSA contributions.
• Monitor employee deductions and employer contributions for accuracy, reviewing payroll deductions and funding reports to ensure proper account funding.
• Investigate and resolve discrepancies between payroll, benefit vendors, and participant accounts.
• Prepare reconciliation reports and summaries for management review.
• Audit benefit deduction entries for bi-weekly payroll and develop additional deduction audits as needed.
• Review and revise departmental processes for deduction entries and payroll activities (including running internal audits and reconciling contributions).

Data Analysis, Compliance & Special Projects

• Extract data and use information to conduct analyses and audits on various benefit programs (including managing/converting all file feeds).
• Participate in local and national benefit surveys, ensuring data accuracy and submission by stated deadlines (including maintenance of benefit records and documentation).
• Maintain accurate records and audit documentation to support annual audits, open enrollment activities, and year-end benefit reporting.
• Run ad hoc reports upon request from various departments.
• Serve as a project team member on major benefit initiatives as deemed necessary.
• Assist with special projects related to benefits administration and process improvement as needed.
• Perform all other related duties as assigned.

Qualifications & Requirements

• Education: Bachelor’s degree in Human Resources, Business Administration, or a related field preferred.
• Experience: [Insert number] years of experience in benefits administration, LOA management, and benefits reconciliation.
• Systems: Proficiency in HRIS systems (Paylocity preferred) and advanced skills in Microsoft Excel for auditing and data analysis.
• Knowledge: Strong understanding of FMLA, ADA, COBRA, ERISA, and other benefits-related compliance laws.

Key physical and mental requirements:

• Ability to lift up to 50 pounds
• Ability to push or pull heavy objects using up to 50 pounds of force
• Ability to sit for extended periods of time
• Ability to stand for extended periods of time
• Ability to use fine motor skills to operate office equipment and/or machinery
• Ability to receive and comprehend instructions verbally and/or in writing
• Ability to use logical reasoning for simple and complex problem solving

FLSA Classification: Non-exempt

Southeast Primary Care Partners is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

12/2024