Benefits Operations Specialist

Benefits Operations Specialist

Requirements

• Bachelor’s degree or equivalent experience in Human Resources, Business Administration, or a related field.
• 5 – 7 years of experience in health and welfare benefit administration.
• Strong proficiency with MS Excel, PowerPoint, and Word.
• Previous experience creating business processes.
• Functional skills and leadership behaviors aligned to Guardian’s HR Capability Model: A natural curiosity to learn about the business, HR function, and industry within which you are working. (Business Acumen)
• Experience and an invested interest in leveraging data to influence decision making outcomes. (Data Judgment)
• Ability to demonstrate an understanding of the bigger picture, and align your work, decisions, and ideas with the overall goals of the function and organization. Excellent judgment: Thinks ahead, anticipates questions, plans for contingencies, and escalates issues when appropriate (Strategic Thinking)
• Experience in building relationships and collaborating with colleagues at all levels. Ability to partner with stakeholders to deliver project objectives. Ability to work independently and as part of a team. (Relationship Management/ Collaboration)
• Experience an understanding of the importance of effectively attracting, developing, and retaining top talent within an organization. (Talent Management)
• Proven ability to be flexible and adaptable in the face of changing circumstances. Ability to prioritize and handle multiple tasks in a demanding work environment. (Agility)
• An elevated level of professionalism and a sense of urgency to ensure expectations are met.
• Excellent problem-solving and analytical skills; proven ability to research, follow up, and resolve complex issues or problems surfaced by the team.
• Excellent interpersonal skills; strong oral and written communication skills; ability to present complex issues/data with a high level of clarity and impact.

Responsibilities

• Serve as a subject matter expert on Guardian’s plans and administrative procedures and key resource for day-to-day tier 3 escalations related to eligibility, enrollment, and claims.
• Overseeing the Field Representative billing process and collaborating with internal stakeholders and the billing administrator to resolve billing disputes.
• Acting as the tier 3 escalation contact to resolve plans/member escalations by leveraging the case management system.
• Performing as the secretary for the Benefits Appeal Committee (BAC), reviewing, researching, presenting, and responding to administrative plan appeals.
• Processing all health, welfare, and wellness vendor invoicing and biweekly payments.
• Managing health account funding and reconciliations.
• Reviewing weekly vendor files and reporting for accuracy, completeness, and conducting annual headcount audits.
• Participating in benefits administration systems testing.
• Supporting benefit communications reviews.
• Maintaining all health, welfare and wellness process documents, plan documents, intranet sites, and call center reference documents.
• Coordinating and executing benefit events.
• Have responsibility in reviewing and maintaining all compliance and disclosure requirements.

Preferred Qualifications

No preferred qualifications provided.