LEAD INSURANCE BENEFITS SPECIALIST

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Lead Insurance Benefits Specialist

Purpose: This position is responsible for enrolling, approving, monitoring changes, and terminating employee benefits based on employment information from HR. This position is also responsible for reconciling billing statements with payroll deduction records and processing payments to insurance and benefits providers. The performance of these duties requires a detail-oriented person with the ability to review large volumes of detailed information for accuracy and completeness, as well as thorough knowledge of the benefits available to our employees through the various health insurance and cafeteria benefits plans.

Reports to: Executive Director of Finance

Primary Job Responsibilities:

• Process and reconcile billing statements from the State Health Plan insurance provider and approximately 15 Cafeteria Benefits providers monthly.
• Assist school system employees and former employees with their health insurance and cafeteria benefit plan questions.
• Prepare written communications to employees regarding their eligibility for participation, changes in their benefits, plan options or plan availability; inform employees when their plan has been changed or discontinued.
• Participate in New Employee Onboarding to educate new employees on benefit offerings, plan details, enrollment process, etc.
• Process incoming enrollment and benefit change forms; checking for completeness and accuracy, checking for the appropriateness of the action requested and taking the appropriate actions to implement the changes requested by employees.
• Contact employees at their place of work and at home to obtain any needed missing information.
• Coordinate the billing of employees for continuation of coverage in employee separations, leave without pay or family medical leave situations, and tactfully collect past-due amounts from employees as needed.
• Process check requests through A/P for the collected funds for those employees on leave.
• Assisting prospective retirees with their benefit end date and processing the paperwork in a timely manner to ensure their retiree insurance coverage to the State ORBIT System has been processed.
• Advise employees resigning or going on Long Term Disability regarding their insurance coverage options and how to pay for those benefits.
• Balance plan billings with payroll deduction records, making any corrections to the billing statements to account for coverage changes, collecting missing payments and correcting for deductions in error, preparing payment requests and sending the appropriate forms and paperwork to plan vendors.
• Calculate, prepare and key “double” insurance deductions for ten-month employees who do not receive compensation during the summer months but whose coverage continues over the summer.
• Process refund requests when overpayments are made or when changes in benefits coverage require refunds to the employee; also coordinating the processing payments in arrears with the employee and with the Payroll Department.
• Deal independently and tactfully with employees with a wide variety of backgrounds and levels of understanding in such a way to assure that each one gets the maximum benefits legally available to them.
• Coordinate Open Enrollment with insurance vendors and assist employees with all questions and or issues that may arise during Open Enrollment.

May2024

• Negotiate and coordinate benefit products offered to RSS employees and ensure contracts are signed correctly and promptly for the insurance providers.
• Process the employee benefit selections for all employee deductions and summer escrow for ten-month employees after Open Enrollment from both the State Health Plan and the cafeteria benefits vendor.
• Complete MetLife death claim for employees or dependents who have passed away while employed with Rowan-Salisbury Schools for the basic life and supplemental life policies.
• Upon resignation or retirement from the school system, this position completes conversion paperwork for employees with the MetLife benefit.
• Coordinate garnishments with payroll received from the State Health Plan for overpayments to employees for benefits by Blue Cross Blue Shield.
• Work directly with third party vendor on a monthly basis uploading employee payroll files to assist with ACA reporting.
• Assist with preparing 1095-c forms for all employees once a year. Performs other duties as assigned.

Qualifications :

• Three years benefits/insurance administration experience
• Associate degree in related field, or any like combination of education and experience.
• Strong initiative and ability to anticipate issues proactively.
• Ability to succeed in a fast-paced environment.
• Ability to work and solve problems independently as well as part of a team
• Excellent computer skills to include Microsoft Office products
• Professional and strong verbal and written communication skills, and interpersonal skills Proven track record of reliability and responsibility.
• Detail oriented with strong organizational and administrative skills.
• Discreet, able to handle confidential and proprietary information appropriately.
• Ability to review large volumes of detailed information for accuracy and completeness.
• Knowledge of benefits available to RSS employees through the various health insurance and cafeteria benefit plans is preferred.

Physical Requirements:

• Requires the occasional exertion of up to 10 pounds of force
• Regularly requires sitting, speaking, or hearing, using hands to finger, handle or feel and repetitive motions
• Occasionally requires standing, walking, stooping, kneeling, crouching, or crawling with hands and arms, pushing, or pulling and lifting
• Requires preparing and analyzing written or computer data, operating machines and observing general surroundings and activities
• Ability to work in a moderately noisy location (e.g. business office, light traffic)

Term of Employment: 12 months

Proposed Salary : Grade L