Senior Benefits Administrator
New
T
TebraHealthcare software
United States - RemoteFull-TimeSenior
Salary90,000 - 103,000 USD per year
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Job Details
- Experience
- 5 years of direct experience dedicated to health & welfare plan administration.
- Required Skills
- Microsoft ExcelWorkdayHIPAA
Requirements
- Bachelor’s degree in Human Resources, Business Administration, Finance, or a related field, or equivalent practical experience.
- 5 years of direct experience dedicated to health and welfare plan administration.
- Demonstrated experience managing self-insured or self-funded medical plans.
- Experience working with stop-loss insurance, TPAs, and PBMs.
- Experience administering benefits using Workday.
- Advanced MS Excel skills, including Pivot Tables, VLOOKUP/XLOOKUP, and data modeling.
- Deep functional knowledge of ERISA, ACA, HIPAA, COBRA, and IRS Section 125 rules.
- CEBS, SHRM-CP/SHRM-SCP, or PHR/SPHR certification preferred.
Responsibilities
- Monitor medical and prescription drug claims, identify trends and cost drivers, and partner with plan actuaries and brokers.
- Coordinate stop-loss renewals, track claims against stop-loss thresholds, and submit reimbursement filings.
- Oversee relationships with TPAs, PBMs, benefits brokers, and carriers, ensuring execution against SLAs.
- Partner with Payroll and Accounting on billing, claims funding, reserves, and employee contribution and invoice reconciliations.
- Lead annual open enrollment, including system updates, employee communications, informational sessions, and post-enrollment audits.
- Manage enrollment changes, qualifying life events, dependent eligibility verifications, and COBRA processing.
- Support disability programs and align benefit premiums during active FMLA and leave-of-absence periods.
- Ensure regulatory compliance and maintain plan documents, SPDs, SBCs, and Form 5500 filings.
- Coordinate nondiscrimination testing and lead annual 401K and ongoing dependent eligibility and enrollment audits.
- Handle escalated employee claims and draft benefits communications about plan features, cost-saving tools, and wellness incentives.
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