The Corporate Sr. Benefits Specialist provides benefit administration and customer service to Corporate employees and provides support and education to the facility Human Resource Departments for active employee benefit plans (medical, dental, vision, life insurance, short term and long term disability, 401k, flexible spending accounts, COBRA, employee assistance program, etc.) and other ancillary benefit programs. The Corporate Sr. Benefits Specialist will interface with senior management and HR team members by leading projects and providing consultation on industry best practices.
Audits enrollment elections, resolves claims, enrollment, eligibility, and related issues for active employees on health and welfare plans. Administers and interprets plan provisions for employees and keeps abreast of healthcare best practices. Researches and updates government-implemented changes to healthcare plans and serves as a liaison with COBRA and various TPAs. Ensures accurate reporting to all benefits vendors and verifies accurate entries in UKG, and various other programs ensuring compliance with ERISA, HIPAA and all applicable state and federal regulations.
ESSENTIAL JOB FUNCTIONS
1. In collaboration with the Corporate Benefits Supervisor, incumbent is responsible for the planning and administration of the various employee benefits plans including enrollment, qualified status changes, open enrollment, and terminations.
2. Responsible for data entry based on employee’s elections, qualified status changes, and open enrollment
3. Advises and counsels management and employees on existing benefit plans.
4. Researches and corrects benefit enrollment issues and/or benefit carrier file discrepancies in a timely basis.
5. Reviews billing statements for accuracy and investigates any discrepancies for assigned benefit plans.
6. Provides vendors with appropriate documentation for enrollment and billing purposes, as applicable
7. Produces various reports for enrollment including; deductions and plan participation as needed.
8. Maintains accurate records and interfaces with accounting and auditors effectively and efficiently.
9. Responsible for 401(k) Plan interface with Fidelity related to timely processing of accurate uploading.
10. Collaborates with auditors in the annual audit of the plan. Ensures all required documents for a 401(k) Plan audit are readily available.
11. Ensures all facilities are aware of proper procedures related to 401(k) Plan administration.
12. Collaborates with appropriate members of the Corporate HR team and vendors to ensure that non-discrimination testing is performed timely and in accordance with regulations and plan document.
13. Leads open enrollment projects, 1095-C filings, 5500 filings, and other benefit projects as needed.
14. Analyzes employee utilization of benefits on an ongoing basis and assists with planning and implementation of the annual open enrollment process, new benefit plans, and other employee information sessions and events as required.
15. Assists in the management of the benefit plan renewal process. Works with health insurance carriers and management to develop benefit implementation strategies and plans.
16. Coordinates the implementation of new carriers and products as related to setup, system input and implementation of benefit business processes and rules.
17. In collaboration with vendors ensures that enrollment/transfers/election issues related to benefits are addressed and resolved in a timely basis. Addresses concerns in a timely and efficient manner.
18. Monitors and coordinates the processing of death claims to ensure compliance with policy, contractual provisions and relevant laws and regulations.
19. Creates communication for participants concerning changes to plans and updates website.
20. Maintains informed on any legal or regulatory changes affecting the administration of benefits and ensures that other HR professionals receive the appropriate updates timely.
21. Facilitate weekly meetings with UKG benefits team to resolve outstanding issues.
22. Keeps immediate supervisor informed of any benefit related concerns/issues and collaborates to address issues on a timely basis.
23. Analyze results of surveys and develops specific recommendations for review by management.
24. Processes medical support orders, evidence of insurability reports, COBRA billing administration, and/or LOA plan administration based on report output.
25. Works collaboratively with AHMC colleagues to deliver exceptional customer service and build cohesive interdepartmental relationships.
26. Assists HR offices at the facilities in addressing complex benefit issues.
27. Ensure employee coverage changes are updated with benefit vendors in a timely manner.
28. Supervises maintenance of enrollment, application, and claims records for all benefit plans.
29. Develop and implement benefit training program.
30. Works with a high level of integrity and maintains confidentiality.
31. Abides by AHMC Code of Conduct and HIPAA compliance.
32. Performs other duties as assigned or required.
Five+ year’s professional experience in benefits administration for a medium to large organization.
Supervisory experience in benefit administration preferred not required.
Detailed knowledge of employee benefits and the regulations, which govern, self-funded programs.
Knowledge of all pertinent federal and state regulation, filing and compliance requirements effecting benefit programs, including ERISA, HIPAA, ADA, ACA, worker’s compensation, COBRA, FMLA, IRS plan restrictions and other related regulations.
Project and team management/leadership skills experience.
Advanced Microsoft (Excel, Access, Word, Outlook, PowerPoint, Publisher, etc.) and database (UKG, People Soft, etc.) experience. Must be proficient with Microsoft Excel.
Ability to create and comprehend reports and spreadsheets
Strong written, verbal, and presentation skills
Strong analytical, problem solving and research skills
Must be detail oriented and able to work effectively with all levels of personnel.
Ability to work and communicate with both internal and external employees and vendors in a professional and effective manner
Ability to organize, prioritize, and follow through to completion on multiple tasks.
Adapts to meet changing business needs
Bachelor’s degree in Human Resources, Business Administration or related experience preferred
CEBS, PHR, SPHR, OR CBP certification a plus
AHMC provides management services to AHMC Anaheim Regional Medical Center with 223 beds, Garfield Medical Center with 211 beds, Greater El Monte Community Hospital with 115 beds, Monterey Park Hospital with 102 beds, San Gabriel Valley Medical Center with 273 beds, Seton Medical Center with 357 beds, Seton Medical Center Coastside, a 116-bed skilled nursing facility, and Whittier Hospital Medical Center with 172 beds. The facilities are Medicare and Medi-Cal certified and accredited by The Joint Commission on Accreditation of Healthcare Organizations. The hospitals provide healthcare services reimbursed by Medicare, Medi-Cal, traditional insurance plans, PPO, HMO and under capitated arrangements.