Benefits Specialist

The Employee Benefits Specialist plays a key role in supporting the organization’s Total Rewards and benefits operations. This position ensures day-to-day benefits processes run smoothly, accurately, and in alignment with applicable regulations. The Specialist is responsible for executing benefit changes in HR systems, maintaining clean data, supporting audits and annual enrollment, and delivering responsive service to associates and HR partners.

This role partners regularly with internal teams, external vendors, and cross-functional stakeholders to resolve issues quickly, maintain compliance standards, and provide a consistent experience for employees navigating benefit-related needs.

Benefits Administration & Processing

• Administer benefit updates and changes throughout the employee lifecycle, including new enrollments, eligibility updates, qualifying events, job changes, and terminations in accordance with plan guidelines and federal requirements.
• Ensure transactions are completed with accuracy and within required timelines to support employee coverage and vendor reporting.

Associate & HR Support

• Serve as a knowledgeable point of contact for benefit-related questions from associates and HR teams, providing clear and accurate guidance on plan eligibility, coverage rules, and administrative processes.
• Respond through multiple service channels (case management tools, email, and phone) while maintaining a customer-focused approach.

HR Systems, Data Accuracy & Auditing

• Update, validate, and reconcile benefits information across HR and vendor platforms (such as HRIS systems and third-party enrollment tools).
• Perform recurring audits to confirm data integrity, identify discrepancies, and support documentation needs tied to compliance requirements.

Compliance & Confidentiality

• Support adherence to benefit program regulations and requirements, including privacy and eligibility-related rules tied to HIPAA, COBRA, and qualifying life event standards.
• Protect sensitive personal and health-related information and ensure appropriate handling of confidential employee records.
• Assist with administration of Qualified Medical Child Support Orders (QMCSOs) and related documentation processes.
• Contribute to open enrollment readiness and execution, including system testing, validation of plan setup, data review, and employee support during the enrollment period.
• Provide operational support for wellness initiatives, serving as the primary administrator for program questions and maintaining accuracy of wellness program participation data, including surcharge and reporting validation.
• Review and troubleshoot vendor error reports, eligibility discrepancies, and file processing issues.
• Partner with vendor contacts and internal teams to resolve integration challenges, correct data problems, and improve service delivery.

Billing, Invoicing & Financial Coordination

• Compile and submit monthly benefits invoices and coordinate with Finance to support payment processing and reconciliation activities.
• Assist with audit follow-up, documentation, and issue resolution related to billing accuracy and vendor charges.
• Create and maintain job aids, process documentation, and standard operating procedures to support consistency and knowledge-sharing.
• Identify and recommend improvements to workflows, tools, and service practices to enhance efficiency and reduce errors.

Reporting & Data Requests

• Provide benefits-related reports and data files to internal partners, vendors, and auditors, including coverage verification requests, census/plan reporting (e.g., Medicare-related needs), and compliance documentation.

Leave of Absence Benefits Support

• Partner with the Leave Management team to coordinate benefit updates connected to leave events, including starting and ending leaves and any associated qualifying event changes.
• Communicate with employees on leave regarding premium collection, coverage continuation, and reinstatement processes when applicable.

Education

• Bachelor’s degree in Human Resources, Business Administration, or a related discipline required.

Experience

• 3–5 years of experience supporting or administering employee benefit programs in a corporate environment.
• Working knowledge of benefits billing processes and reconciliation practices strongly preferred.
• Experience using HRIS and benefit administration platforms (e.g., SAP Success Factors) and vendor systems (e.g., Benefit Focus) preferred.

Regulatory Knowledge

• Solid understanding of compliance standards affecting employee benefit plans, including HIPAA, PHI handling, COBRA, and qualifying life event requirements.

Technical Skills

• Proficient in Microsoft Excel, Word, Outlook, and Teams.
• Comfortable working with reporting, data review, and spreadsheet analysis.
• Familiarity with eligibility file feeds, vendor integrations, and data transfer processes is a plus.