Benefits Specialist

Benefits Specialist

The Benefits Specialist will manage employee leave programs and supports benefits compliance across the organization. Serving as the first point of contact for benefits, and leave vendors, this role oversees leave administration, vendor performance, regulatory compliance, and disability pay coordination. The position also supports 401K, health and welfare benefits operations, premium audits, required reporting, and annual Open Enrollment to ensure accurate and compliant employee experience.

Essential Duties and Responsibilities

• Daily Management: Administer health and welfare benefit plans including enrollments, terminations, beneficiary updates, qualifying life events, dependent verification, COBRA coordination, and Qualified Medical Child Support Orders (QMCSOs).
• Employee Benefits & Retirement Support: Serve as the primary point of contact for employee questions related to benefits programs, and 401(k) offerings. Educate employees on plan provisions, eligibility requirements, enrollment processes, and available resources.
• Benefits Education & Employee Engagement: Coordinate benefits onboarding sessions for newly hired employees and support the development and delivery of employee benefits education programs. Assist with benefits orientation meetings, Open Enrollment activities, communication campaigns, and ongoing educational initiatives that increase employee understanding, engagement, and utilization of company-sponsored benefit programs.
• Wellness Program Administration: Support the administration and promotion of company-sponsored wellness initiatives designed to improve employee health, well-being, and engagement. Coordinate wellness campaigns, biometric screenings, health awareness activities, wellness challenges, and vendor-sponsored programs while partnering with benefit providers to maximize participation and program effectiveness.
• HRIS Data Integrity: Ensure benefits data seamlessly integrates between the internal HRIS and external carrier systems, resolving any data file transfer errors.

• Case Management: Assist with the administration of leave cases, including FMLA, Short-Term Disability (STD), Long-Term Disability (LTD), parental, military, and bereavement leaves. Partner closely with HR and Payroll to ensure employees receive accurate and timely pay while on approved leaves of absence.
• Leave Communication & Coordination: Partner with HR to assist with communicating approved leave dates, status changes, return-to-work requirements, and required employee documentation. Escalate accommodation requests and ADA-related matters to the appropriate HR leader.
• Tracking & Returns: Track leave timelines and critical deadlines, distribute required notices, and coordinate premium collections during unpaid leaves. Ensure all leave-related documentation is complete and maintained in accordance with company policies and regulatory requirements.
• Manager Consultation: Educate and advise managers on leave procedures, employee rights, job restoration requirements, attendance considerations, and best practices for supporting employees throughout the leave lifecycle.
• Leave Analytics: Develop and maintain dashboards and reports related to leave utilization, claim activity, employee leave trends, vendor performance, and compliance metrics.
• Leave Process Improvement: Identify opportunities to streamline leave administration processes, improve employee communications, and enhance compliance practices.

• Legal Monitoring: Track changes to federal, state, and local regulations, including ERISA, ACA, COBRA, HIPAA, FMLA, and applicable state leave laws, and recommend policy or process updates.
• Compliance and Invoice Auditing: Conduct periodic audits of leave administration, benefit eligibility, payroll deductions, and vendor performance to identify compliance risks and recommend corrective actions. Assist with performing monthly premium reconciliations and billing audits for insurance carriers to identify data errors and control costs.
• Mandatory Filings: Assist with preparing and submitting statutory annual filings, including Form 5500s, Medicare Part D, ACA 1094/1095 reporting, and non-discrimination testing.
• Financial Administration: Process, audit, and reconcile benefits and insurance-related invoices in a timely and accurate manner.
• Reporting & Analytics: Develop and maintain reports related to benefits participation, leave activity, compliance metrics, wellness engagement, and vendor performance to support Total Rewards decision-making.

• Perform additional duties and special projects as assigned.

Qualifications & Skills

• Bachelor's degree in human resources, Business or Healthcare Administration.
• 5+ years of progressive experience administering complex leave programs, compliance, and corporate benefits administration.
• Knowledge of ERISA, HIPAA, COBRA, FMLA, ACA, and other applicable benefits and leave regulations.
• Demonstrated ability to interpret plan documents, benefits policies, and regulatory requirements while ensuring compliance and consistent application.
• Strong analytical skills with experience conducting benefits audits, reconciling vendor invoices, and identifying trends through reporting and metrics.
• Excellent oral, written, presentation, and interpersonal communication skills with the ability to explain complex benefits information to diverse employee populations.
• Hands-on experience with modern HRIS platforms (e.g., Workday, ADP, UKG) and proficiency in MS Excel for auditing.
• Strong customer service orientation and commitment to delivering a positive employee experience.
• Experience leading annual open enrollment, benefits communications, and employee wellness initiatives preferred.
• Willingness to get professional credentials such as PHR, SHRM-CP, or specialized designations like CBP, CEBS, or DMEC CLMS (Certified Leave Management Specialist) are highly preferred.