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Benefits Service Specialist III
Are you a person interested in unleashing your potential by elevating the experience of others? Do you love helping people in a meaningful way on an epic scale? Are you an ardent leaner who's always looking to improve? Do you thrive on pulling out of the matrix of automated responses?
Our mission is to help people. We are the ones that navigate the complex universe of insurance benefit programs and deliver smiles. From the joy of birth to the grief of loss, we stand next to our clients.
We are seeking a Benefits Service Specialist Ninja - Level Three to work collaboratively with a faced paced, cross-functional team to create a world class experience. The ideal candidate thrives in an agile environment and has passion for fostering relationships.
We like people who are excited about the last bullet point: "Other duties as assigned." We also like those who want to read the fine print:
The Benefit Services Specialist (BSS) serves as the primary point of contact for our TotalSource clients and our internal service and business partners as it relates to the processing, guidance and governance of all TotalSource Health and Welfare plan administration services and benefit programs. The TotalSource Health and Welfare plan is a robust offering with a full array of national and regional plan and carrier choices providing Medical, Dental, Vision, Disability, FSA/HSA/OCB and voluntary benefit programs that support a client's ability to attract and retain talent.
The BSS provides guidance and research in response to a wide variety of benefit related questions, requests, projects and issues presented by internal partners, clients and the worksite employee. That guidance includes, but is not limited to, health and welfare benefit concepts, best practices including benchmarking assessments, eligibility, dependent eligibility, qualifying events, appeals/claims handling, confirmation statements and audits along with compliance & technical guidance in accordance with state and federal law in supporting clients and the worksite employee. This will ensure accuracy of administrative practices in supporting the TotalSource master benefit program. The BSS works closely with various internal business partners, particularly with HR Business Partners and Client Relations Executives and organizational Managers on consultative benefits related projects (i.e. engaging key demographics of workplace, communicating benefits to build engagement and value). Higher levels of the position may assist with team training needs including coordination as well as mentoring and oversight and governance of the day to day operations. In addition, the BSS will serve as the liaison between the client and other ADP and non-ADP service providers such as the various insurance carriers and human resource consultants in reference to supporting administrative services.
Higher levels of this job family, will typically deal with the more complex client scenarios (represented by size, scope of services or complexity of client benefit programs) and provide "mentorship" and training to less senior levels, and assist them with problem resolution. In addition, the higher levels of this job family will demonstrate subject matter expertise in the areas of benefits administration services, health & welfare benefit concepts, systems technologies, and/or compliance (i.e., ERISA, Section 125, ACA). Higher levels may also lead project and stretch initiatives, assist Team Lead and Manager in assigning priorities, direct team mates, expediting work flow, etc. Level IV supports the team leader in their absence and provides project management support and coordination during significant events such as Annual Open Enrollment. This job family allows for specialization in the type of consultative support provided.
The BSS is also charged with assisting the client and internal team members regarding technical troubleshooting of MyTotalSource, TotalSolutions tool, WFN, EV4 and eBIS systems including feature/functionality, navigation, security, carrier connection issues, reporting, data integrity and event transaction processing. The BSS acts as a subject matter expert in the areas of benefit administration standard operating and client operating procedures, including issues surrounding compliance of ACA, HIPAA, etc. and provide SME assistance relating to health and welfare benefit program concepts, COBRA, FSA, ACA, LTD/STD, etc.. Provides proactive, consultative guidance and information to the client and internal business partners as it relates to TotalSource best practice, compliance, standard and client operating procedures. As subject matter expert, the BSS provides proactive, consultative guidance to client regarding benefit administration services and related best practices/standard operating procedures, employee eligibility and enrollment, and compliance. Meet the expectation and requirements of all clients. The BSS will also perform quality assurance checks in governance and oversight of transaction processing and back office deliverables. Perform ad hoc data analysis and audits, as needed.
Benefits Service Specialist III associates will focus less on administrative and transactional duties and more on best practice and compliance guidance, product knowledge & support, client/ vendor relations, mentorship and training of newer lower level associates and leadership.
The segments with which they are aligned have Key Account clients which are larger and more complex.
Administers, manages and/or governs a variety of benefit plans on a day-to-day basis through processing of various transactions and events within and potentially outside of the Total Source systems, including but not limited to pending enrollments, dependent verification, new hire, life and termination events and annual open enrollment processing.
- Partners with back office teams to coordinate transaction processing, audits and ad hoc or regular deliverables.
- Performs various data integrity and enrollment/eligibility audits. Researches and resolves issues identified through those routine audits.
- Reviews, maintains, and modifies standard operating and client operating processes and procedures for benefits administration. Identifies opportunities for potential improvement in enrollments and benefits administration. Makes recommendations to management and peers.
- Manages and monitors data flow and integration including carrier connections, payroll and/or processes manual carrier updates. Works in conjunction with various team members to resolve errors and issues in a timely and accurate manner. Escalates programmatic issues to appropriate team members, carriers or HRBPs, as appropriate.
- Provide tier 2 client and internal business partner service support. Communicate and execute benefit policy changes, as necessary. Research and resolve complex client benefit problems and questions, Coordinates with other TotalSource associates.
- Works with benefit providers to support client benefits administration and resolve eligibility issues.
SERVICE and PRODUCT SUPPORT
- Provides service support related to the administration of health and welfare benefit programs to the client and internal business partners and service team via phone, CRM, email or in person, regarding standard or client operating procedure, best practice/business process, the resolution of participant benefit plan, insurance provider and/or other client problems.
- Coordinates communication with appropriate HR or Benefits associates, internal business partners or carrier resources to expedite responses to critical process, operating, client or participant situations.
- Utilizes extensive benefits/product/process experience to identify issues, troubleshoot client or service team problems and assist with a resolution. This would include but not be limited to issues related to participant coverage, administrative processes, compliance, carrier connections, payroll, and TotalSource systems functionality.
- Continually upgrade knowledge and skill base relating to health and welfare benefit programs including compliance, standard operating procedures, administrative practices and processes and other benefit products, as applicable, to increase proficiency in a support capacity. May champion and/or assist in assessing regulatory changes and process impact, process improvement or other service application rollouts, and service training.
- Acts as a Liaison between the client, HRBP, CRE, ACA COE and the carriers to explain benefits related processes.
- Partners with various team members to coordinate and execute Annual Enrollment process for clients.
- Assists in analyzing plan and service requirements used in transitioning a client to service from implementation. Ensures system configuration, standards and client operating procedures, process guides, check lists, and knowledge base are accurate and complete.
- Mentors all levels of service associates. Provides instruction and guidance on health and welfare benefit programs, administrative process and procedures, compliance related questions or issues, troubleshooting system issues, and soft skill development.
- Works with newly hired associates as a coach. Identifies training needs.
- Develops, coordinates and may deliver training or booster classes to all levels.
- Acts as the primary point of contact for client, internal business partners and HRBP/CRE/GM related to benefits administration best practice, transaction processing, compliance standards and client operating procedures and responding to inquiries and resolving issues.
- Proactively works to identify problems and offer solutions to improve the internal operation and administration of the plans.
- Responds to complex client issues and escalations to ensure that support rendered meets or exceeds the client's needs to ensure client satisfaction.
- Works with the various TotalSource service providers in order to identify and resolve issues.
- Takes a proactive approach to establish systematic processes and procedures that will reduce or eliminate errors.
- Develops and implements the workflow (both manual and electronic) to ensure that the transactions are accurately processed by TotalSource service providers such as Section 125/FSA, COBRA, 401(k), etc.
- Performs other related duties as assigned.
- 3-5 years of experience in Benefits Administration functions. Payroll, Accounting and HRIS experience a plus.
- In-depth knowledge of TotalSource (or other enterprise PR & H&W) products and a proven proficiency of navigating the ADP organization (or other) to resolve client requests required.
- Bachelor's degree in Human Resources, Business Administration, Information Technology or equivalent in education and experience required