Tebra Senior Benefits Administrator at Tebra manages day-to-day administration and strategic alignment of health and welfare plans. Oversees self-insured medical plan performance, TPA relationships, and compliance with ERISA, HIPAA, and ACA.
Responsibilities
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).
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.
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.
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.
Qualification
Experience with ERISA
Required
Experience with ERISA, HIPAA, and ACA compliance
Strong data analytics capabilities for claims evaluation
