POSITION SUMMARY
The Benefits Specialist is responsible for administering the organization’s employee benefits programs while exercising independent judgment, interpreting policies and regulations, and advising leadership on benefits related decisions. This role provides subject matter expertise on health & welfare, retirement plans, leaves of absences, ADA accommodations, worker’s compensation, ancillary plans and wellness initiatives, ensuring an exceptional employee experience, operational accuracy, regulatory compliance per federal and state guidelines and cost effectiveness. The Benefits Specialist partners with HR, Payroll, Finance, and external vendors to manage day‑to‑day processes, improve plan administration, and support annual events (e.g., open enrollment, audits, and renewals). This role functions in autonomy acting as a resource for employees, this position ensures a positive benefits experience while meeting compliance standards and mitigating risk, cultivating workforce stability.
KEY RESPONSIBILITIES
· Benefits Administration: 50%
o Serve as a subject matter expert (SME) for employee benefit inquiries (medical, dental, vision, cafeteria plans, life/AD&D, disability, EAP, wellness) and resolve issues with empathy and accuracy.
o Administer eligibility, including life-cycle events, enrollment, termination, continuation of coverage (COBRA), billing, and claim processes across benefit plans, including coordination with employees, payroll, and carriers.
o Assists Senior Director in administering employee leaves, including but not limited to FMLA, PFL, Disability, Educational Leave, Military Leave, and Personal Leave. This includes, but is not limited to, tracking employee leave timelines, documentation, maintenance, and coordination with the Payroll team.
o Maintain accurate benefits data in HRIS/benefits platforms; reconcile eligibility and deductions with Payroll.
o Manage new hire elections, qualifying life events, and mid-year changes; audit and maintain accurate benefits records.
o Assists in collaborating with external vendors/brokers to resolve escalated issues and ensure optimal service delivery.
o Responsible for submitting monthly exclusion reportion (employee and vendors) to ComplianceNow.
o Support and lead key components in annual open enrollment by taking the lead to plan, coordinating materials, system testing, communications, presentations, audits, post-enrollment corrections and ensure compliance with ACA and other regulations.
o Analyze enrollment, utilization, and renewals.
o Co-lead PPGNY’s Employee Wellness Program and Committee, developing wellness initiatives, communications, and rewards for participants.
o Adminsters the annual health assessment and influenza vaccine compliance program.
o Actively ensure ongoing compliance with ERISA, HIPAA, COBRA, ACA, USERRA, OSHA 300 reporting forms, New York State leaves, and related regulatory requirements through interpretation of regulations and operational recommendations to HR leadership.
o Assist with additional audits, benefit communications, and special benefits projects or enhancements.
· Finance & Data: 15%
o Prepare, reconcile, and process benefit invoices and associated documentation. Execute monthly invoice reconciliations, including discrepancy resolution and vendor follow up.
o Generate reports (enrollment, costs, participation, KPIs) and provide recommendations that contribute to plan renewals with trend analyses.
o Partner with Payroll to ensure accurate pretax/post‑tax deductions and retro adjustments, applying judgment to resolve complex cases requiring interpretation of benefits rules.
· Employee Support and Communication 15%
o Provide SME day-to-day support and training to employees on benefits programs.
o Assist with drafting, revising and delivering benefits communications: guides, FAQs, webinars, onboarding materials, and intranet content.
o Participate in training initiatives and serves as a point of contact for managers and payroll partners to ensure consistent application of benefits and leave processes.
o Promote wellness initiatives and drive utilization of programs that support employee well‑being.
· Process and Continuous Improvement 15%
o Identify process gaps and use data and analysis to recommend policy or procedural changes for leadership review.
o Maintain and enhance SOPs relating to benefits operations, ensuring alignment with evolving regulations and organizational priorities.
o Manage audits, vendor transitions, and system enhancements.
· Other: 5%
o Other duties as assigned