Benefits + Leave Specialist

Job Description:

Position Summary:

The Benefits + Leave Specialist is responsible for the day-to-day administration of employee benefits, wellness, disability, and leave programs. The incumbent serves as the primary point of contact for employee benefit and leave related inquiries and provides timely, high-quality customer service to employees, regulatory compliance, operational excellence and data integrity. The Benefits + Leave Specialist processes benefit changes, administers leave of absence programs, maintains accurate records, and supports other benefit and wellness-related initiatives. The incumbent partners with employees, leaders, vendors, payroll, and Human Resources to deliver an exceptional employee experience while supporting organizational compliance and benefit program effectiveness.

Primary Responsibilities & Duties:

Benefits Administration & Employee Support

• Serve as the primary contact for employee benefits, leave of absence, disability, and workers’ compensation questions and requests

• Educate employees regarding eligibility, enrollment, qualifying life events, and benefit programs

• Process benefit enrollments, terminations, COBRA coordination, status changes, and qualifying life events within HRIS and vendor systems

• Administer programs in accordance with ERISA, HIPAA, ACA, COBRA, FMLA, and other applicable federal and state laws

• Maintain current knowledge of benefit laws, leave of absence regulations, and industry best practices

• Partner with benefit carriers and third-party administrators to resolve escalated employee issues and ensure service level expectations are met

• Troubleshoot issues and escalate complex benefit, leave, and accommodation issues to the Manager, Benefits

• Prepare and analyze routine benefit and leave utilization reports

• Monitor benefit trends, leave activity, and program participation to support decision-making and compliance efforts

Leave & Disability Administration

• Administer leave of absence cases (FMLA, ADA, state-specific leave, personal leave, disability, etc.), ensuring compliance with applicable federal, state, and local regulations

• Provide guidance to employees regarding leaves of absence and disability entitlements

• Maintain data integrity to ensure compliance with applicable federal, state, and local regulations and track return-to-work timelines

• Maintain accurate leave, and employee data within HRIS and vendor systems

• Process reasonable accommodation requests in compliance with ADA standards

• Coordinate with employees, leaders, leave carrier, Human Resources, and Payroll to ensure leaves of absence and disability claims are processed accurately and timely

• Conduct periodic reviews of leave administration practices to promote consistency, accuracy, and compliance

• Establish and maintain standardized leave administration processes, templates, forms, and best practices

Benefit Communications & Initiatives

• Draft and support employee communications related to benefits and wellness programs, including open enrollment content

• Update benefits information on company intranet as needed

• Support implementation of new programs and process improvements from planning through rollout, including communications and employee education

• Support open enrollment preparation, testing, employee communications, and employee assistance

• Participate in compliance audits

• Plan and support implementation of employee well-being initiatives

Billing & Invoice Reconciliation

• Responsible for reconciling benefit-related invoices with enrollment records

• Route invoices for processing and payment

• Track vendor invoices and payments to ensure timely remittance

• Proactively identify and resolve billing discrepancies, partnering directly with vendors and Finance to correct errors undefined

Knowledge / Skills:

• Solid knowledge of benefits-related regulations, including HIPAA, COBRA, FMLA, and state leave laws
• Ability to explain complex benefit and leave rules in plain language and excellent customer service skills
• Strong analytical and problem-solving abilities 
• Strong attention to detail, reconciling records and invoices accurately
• Ability to self-manage and prioritize responsibilities
• Ability to manage sensitive information with discretion and strict confidentiality
• Experience with HRIS or benefits administration systems (Workday experience preferred)
• Highly resourceful collaborator, with the ability to also be effective independently

Minimum Requirements:

• Associate’s degree in Human Resources, Business, or related field, or equivalent work experience
• 2+ years’ benefits administration or progressive Human Resources experience
• Proficient with Microsoft Office, including Excel and PowerPoint skills
• Solid knowledge of pertinent federal and state Human Resources regulations and compliance requirements affecting employee benefits programs, including the ACA, ERISA, COBRA, FMLA, ADA, workers’ compensation, Medicare/Social Security, and DOL requirements

Everwise is an equal opportunity employer. We are committed to creating an inclusive environment for all employees.