Senior Benefits Administrator

Job Overview

Tebra only initiates contact with candidates via email from an official Tebra email address (@ tebra. com , @ patientpop. com , or @ kareo. com ) 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.

Job Description

Stop-Loss Administration: Coordinate stop-loss policy renewals, track claims reaching individual/aggregate stop-loss thresholds, and submit reimbursement filings to carriers.

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.

Key Responsibilities

• 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.
• Your Area of Focus Self-Insured Plan Oversight & Financial Management 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.
• TPA & Vendor Governance: Oversee relationships with Third-Party Administrators (TPAs), Pharmacy Benefit Managers (PBMs), and Benefits broker and carriers.
• 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.
• Health & Welfare Plan Administration Open Enrollment: Lead the annual Open Enrollment process, including system updates, open enrollment communications, employee informational sessions, and post-enrollment audits.
• Life Events & Ongoing Administration: Manage day-to-day enrollment changes, qualifying life events (QLEs), dependent eligibility verifications, and COBRA processing.
• Disability & Leave Coordination: Support short-term/long-term disability programs and align benefit premiums during active FMLA/LOA periods.
• Annual Benefits Audits: Lead annual 401K audit and execute dependent eligibility and enrollment audits throughout the year.

Required Skills and Qualifications

• About the Role 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.
• 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.
• Employee Experience & Communications Escalated Claims Support: Act as the primary point of contact for complex, escalated employee claims issues, serving as an advocate while maintaining plan governance.
• Your Professional Qualifications Education & Experience Bachelor’s Degree in Human Resources, Business Administration, Finance, or a related field (or equivalent practical experience).
• 5 years of direct experience dedicated to health & welfare plan administration.
• Demonstrated experience managing self-insured / self-funded medical plans, including working with stop-loss insurance, TPAs, and PBMs.
• Technical & Analytical Skills HRIS Proficiency: Experience administering benefits using Workday.
• Data & Excel Mastery: Advanced skills in MS Excel (Pivot Tables, VLOOKUP/XLOOKUP, data modeling) to analyze large sets of claims and census data.

Benefits and Perks

• About the Role 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).
• TPA & Vendor Governance: Oversee relationships with Third-Party Administrators (TPAs), Pharmacy Benefit Managers (PBMs), and Benefits broker and carriers.
• Disability & Leave Coordination: Support short-term/long-term disability programs and align benefit premiums during active FMLA/LOA periods.
• Plan Documentation: Maintain updated Summary Plan s (SPDs), Summaries of Benefits and Coverage (SBCs), Plan Documents, and Form 5500 filings.
• Annual Benefits Audits: Lead annual 401K audit and execute dependent eligibility and enrollment audits throughout the year.

Work Location and Schedule

This role is listed as Remote USA with location information shown as Remote USA. The employment type is Full Time.

About the Company

Tebra is the organization connected with this listing. USA Jobs Today displays this opportunity for job discovery only, so applicants should verify company details, application instructions, and eligibility on the official employer website.