Specific Roles & Responsibilities:
- Leads monthly benefits reconciliations across all benefit plans (medical, dental, vision, FSA/HSA, 401(k), etc.)
- Partners with Payroll and Finance to ensure accurate deductions, employer contributions, and vendor billing
- Investigates and resolves discrepancies, ensuring timely and accurate corrections
- Develops and maintains reconciliation processes, controls, and documentation to support audit readiness
- Provides monthly reporting and insights on benefits spend, trends, and variances
- Provides support in managing the financial and operational oversight of the company’s self-insured medical plan
- Reviews and analyzes claims data, stop-loss coverage, and funding levels
- Partners with brokers, TPAs (Third-Party Administrators), and carriers to monitor plan performance and cost drivers
- Tracks and reconciles claims funding, administrative fees, and stop-loss reimbursements
- Identifies trends and recommends strategies to manage costs and improve plan efficiency
- Analyzes benefits utilization, enrollment trends, and cost drivers to inform strategy
- Works with the Director of People Operations to build dashboards and reports to provide visibility into benefits performance
- Supports forecasting and budgeting processes related to benefits spend
- Provides insights and recommendations to People Ops and leadership
- Partner with Finance during the monthly and quarterly close process to ensure accurate accounting of benefits-related expenses and liabilities
- Prepare and validate journal entries related to benefits costs, including claims funding, stop-loss premiums, and administrative fees
- Reconcile benefits-related general ledger accounts and support variance analysis
- Monitor and manage claims funding requirements, ensuring appropriate cash flow for self-insured plan obligations
- Partner with Finance to track timing of large claims, stop-loss reimbursements, and vendor payments
- Provide visibility into short- and long-term funding needs
- Serves as a key point of contact for benefits vendors, brokers, and administrators
- Ensures vendor invoices align with contractual terms and enrollment data
- Supports vendor performance reviews and issue resolution
- Assists in annual open enrollment planning and execution
- Owns carrier file processes, including testing, data reconciliation, and diagnosing data file issues to drive timely resolution.
- Assists in annual open enrollment planning and execution, including carrier implementation, ensuring system readiness, data accuracy, and smooth execution of enrollment processes
- Ensures compliance with all applicable regulations (ERISA, ACA, HIPAA, COBRA, etc.)
- Supports audits, filings (e.g., Form 5500), and documentation requirements
- Maintains accurate plan documentation, controls, and reporting processes
- Bachelor’s degree in Finance, Accounting, HR, or related field
- 5–8+ years of experience in benefits administration, with strong emphasis on financial analysis and reconciliation
- CEBS or other relevant certification is a plus, but not required
- Experience managing or supporting self-insured health plans required
- IBNR experience is a plus
- Strong understanding of benefits compliance and regulatory requirements
- Advanced Excel skills (pivot tables, VLOOKUP/XLOOKUP, data analysis)
- Experience working with HRIS and payroll systems (e.g., Rippling, Dayforce, ADP)
- High attention to detail with strong problem-solving skills
- Ability to manage multiple priorities and work cross-functionally
- Experience in a high-growth/fast-paced environment
- Experience with stop-loss insurance and claims analytics
- Experience building reporting dashboards (e.g., Excel or similar tools)
