<div class="content-intro"><p>Tebra only initiates contact with candidates via email from an official Tebra email address (@<a class="c-link" href="http://tebra.com/" target="_blank" data-stringify-link="http://tebra.com" data-sk="tooltip_parent">tebra.com</a>, @<a class="c-link" href="http://patientpop.com/" target="_blank" data-stringify-link="http://patientpop.com" data-sk="tooltip_parent">patientpop.com</a>, or @<a class="c-link" href="http://kareo.com/" target="_blank" data-stringify-link="http://kareo.com" data-sk="tooltip_parent">kareo.com</a>) or through our applicant tracking system, Greenhouse. We will only ask you to provide sensitive personal information through our official application portal — not via social media or text message. We do not conduct interviews via instant messaging.</p></div><h1>About the Role</h1> <p>We are seeking an experienced and analytical Senior Benefits Administrator to oversee the day-to-day administration and strategic alignment of our health and welfare plans. Reporting directly to the HR Operations Director, this role plays a pivotal part in managing our self-insured medical plan, monitoring plan performance, managing Third-Party Administrator (TPA) relationships, and ensuring compliance across all health and welfare offerings (medical, dental, vision, life, disability, 401K and wellness).</p> <p>The ideal candidate possesses deep expertise in ERISA, HIPAA, and ACA compliance, strong data analytics capabilities to evaluate claim trends, and exceptional employee communication skills to deliver a seamless experience.</p> <h1>Your Area of Focus</h1> <h3><strong>Self-Insured Plan Oversight & Financial Management</strong></h3> <ul> <li>Claims Analysis & Tracking: Monitor ongoing medical and prescription drug claims performance; identify trends, high-cost claimants, and cost-driver patterns in partnership with plan actuaries and brokers.</li> <li>Stop-Loss Administration: Coordinate stop-loss policy renewals, track claims reaching individual/aggregate stop-loss thresholds, and submit reimbursement filings to carriers.</li> <li>TPA & Vendor Governance: Oversee relationships with Third-Party Administrators (TPAs), Pharmacy Benefit Managers (PBMs), and Benefits broker and carriers. Ensure operational execution according to SLAs.</li> <li>Funding & Reconciliations: Partner with Payroll and Accounting to manage weekly/monthly billing, claims funding requests, reserve requirements (IBNR tracking), and employee contribution and invoice reconciliations.</li> </ul> <h3><strong>Health & Welfare Plan Administration</strong></h3> <ul> <li>Open Enrollment: Lead the annual Open Enrollment process, including system updates, open enrollment communications, employee informational sessions, and post-enrollment audits.</li> <li>Life Events & Ongoing Administration: Manage day-to-day enrollment changes, qualifying life events (QLEs), dependent eligibility verifications, and COBRA processing.</li> <li>Disability & Leave Coordination: Support short-term/long-term disability programs and align benefit premiums during active FMLA/LOA periods.</li> </ul> <h3><strong>Compliance & Governance</strong></h3> <ul> <li>Regulatory Reporting: Ensure strict compliance with federal and state regulations, including ERISA, ACA (1094/1095 reporting), HIPAA, COBRA, and FMLA.</li> <li>Plan Documentation: Maintain updated Summary Plan Descriptions (SPDs), Summaries of Benefits and Coverage (SBCs), Plan Documents, and Form 5500 filings.</li> <li>Nondiscrimination Testing: Coordinate annual 105(h) and Section 125 nondiscrimination testing with third-party compliance specialists.</li> <li>Annual Benefits Audits: Lead annual 401K audit and execute dependent eligibility and enrollment audits throughout the year.</li> </ul> <h3><strong>Employee Experience & Communications</strong></h3> <ul> <li>Escalated Claims Support: Act as the primary point of contact for complex, escalated employee claims issues, serving as an advocate while maintaining plan governance.</li> <li>Benefits Communication: Draft clear, accessible employee communications explaining self-insured plan features, cost-saving tools (e.g., telehealth, centers of excellence), and wellness incentive initiatives.</li> </ul> <h1>Your Professional Qualifications</h1> <h3><strong>Education & Experience</strong></h3> <ul> <li>Bachelor’s Degree in Human Resources, Business Administration, Finance, or a related field (or equivalent practical experience).</li> <li>5 years of direct experience dedicated to health & welfare plan administration.</li> <li>Demonstrated experience managing self-insured / self-funded medical plans, including working with stop-loss insurance, TPAs, and PBMs.</li> <li>Professional Certifications (Preferred): CEBS (Certified Employee Benefit Specialist), SHRM-CP/SHRM-SCP, or PHR/SPHR.</li> </ul> <h3><strong>Technical & Analytical Skills</strong></h3> <ul> <li>HRIS Proficiency: Experience administering benefits using Workday.</li> <li>Data & Excel Mastery: Advanced skills in MS Excel (Pivot Tables, VLOOKUP/XLOOKUP, data modeling) to analyze large sets of claims and census data.</li> <li>Regulatory Depth: Deep functional knowledge of ERISA, ACA, HIPAA, COBRA, and IRS Section 125 rules.</li> </ul> <p><strong>#LI-SS1 #LI-Remote</strong></p><div class="content-pay-transparency">&