Benefits Administrator

Job Summary 

The Senior Benefits & Leave Administrator is responsible for the accurate, timely administration of MPowerHealth’s U.S. health & welfare benefit programs and for managing end-to-end leave processes (FMLA, ADA, STD, LTD, and applicable state/local leave programs). This role serves as a primary point of contact for employees and managers regarding benefits and leaves, partners closely with carriers, brokers, and third-party administrators, and ensures compliance with all relevant federal and state regulations (ACA, COBRA, ERISA, HIPAA, FMLA, ADA, and state leave laws). 

In a fully remote environment, this position plays a key role in delivering a high-touch, responsive employee experience through proactive communication, virtual support, and strong cross-functional collaboration with Payroll, HRBPs, and People Operations. 

Essential Job Duties and Responsibilities 

• Administer day-to-day health and welfare benefits (medical, dental, vision, HSA/FSA, life/AD&D, disability, EAP, retirement), including new hire enrollments, qualifying life events, terminations, and rehires. 
• Conduct ongoing eligibility and dependent audits; reconcile monthly vendor invoices and resolve discrepancies to ensure accurate billing and cost management. 
• Lead annual and mid-year enrollment processes, including project planning, system configuration/testing, employee communications, virtual support sessions, and data/file validation. 
• Manage COBRA events (in-house or via TPA) and ensure timely and compliant notices and processes. 
• Maintain benefit plan documentation (plan documents, SPDs, SMMs) and coordinate updates/changes with internal stakeholders, brokers, and carriers. 
• Track and report ACA data; support the annual 1095-C/1094-C process, 5500 preparation, nondiscrimination testing, and other required filings and audits. 
• Own the leave administration lifecycle from intake through return-to-work, including eligibility determination, required notices, designation, documentation tracking, and case resolution. 
• Coordinate STD/LTD claims with carriers; align leave pay impacts with payroll timelines and ensure premium collection/arrears tracking during unpaid leaves. 
• Facilitate the ADA interactive process, including documentation review, accommodation tracking, manager guidance, and outcome documentation in accordance with compliance and confidentiality standards. 
• Partner with HRBPs and managers on leave planning, return-to-work strategies, coverage considerations, and communication cadence while protecting employee privacy and confidential medical information. 
• Maintain accurate benefit and leave records in the HCM and/or leave management system; produce regular status reports and metrics (open cases, RTW timelines, expirations, claim trends, SLAs). 
• Ensure ongoing compliance with ACA, ERISA, HIPAA, COBRA, FMLA, ADA, and applicable state/local leave laws; monitor regulatory changes and recommend updates to processes and policies. 
• Own and continuously improve SOPs, workflows, templates, and employee-facing communications to drive consistency, scalability, and audit readiness. 
• Prepare and analyze routine dashboards, including enrollment statistics, open enrollment participation, invoice variance trends, leave volume and duration, and service-level adherence. 
• Process benefit enrollments and changes through a modern HRIS/benefits platform (e.g., UKG, Workday, Oracle) and validate carrier feeds/EDI files; coordinate troubleshooting and issue resolution. 
• Deliver high-quality employee support via ticketing, email, and virtual office hours; resolve complex cases and serve as an escalation point with carriers, TPAs, and brokers as needed. 
• Develop clear FAQs, job aids, and guides; deliver brief virtual trainings for employees and managers related to enrollment, life events, leave basics, and policy updates. 
• Support vendor performance management by tracking issues, monitoring SLAs, documenting escalations, and identifying opportunities to improve service delivery and employee experience. 
• Leverage technology and automation tools where appropriate (e.g., workflow routing, ticketing systems, knowledge bases) to streamline processes and enhance the remote employee experience. 
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Experience & Education 

• Bachelor’s degree in Human Resources, Business, or related field, or equivalent applicable experience. 
• 5+ years of hands-on U.S. benefits administration and leave management experience in a multi-state environment; healthcare, high-growth, or self-funded plan experience strongly preferred. 
• Experience working with a modern HRIS/benefits platform (e.g., UKG, Workday, Oracle) required; exposure to EDI/carrier file feeds strongly preferred. 
• Strong knowledge of U.S. benefits compliance requirements and regulations including ACA, ERISA, HIPAA, COBRA, FMLA, ADA, and state/local leave laws. 
• Proven ability to work effectively in a fully remote environment, manage competing priorities independently, and maintain a high level of responsiveness and professionalism. 
• Detail-oriented with strong follow-through and a high standard for data integrity; experienced with invoice reconciliation and audit-ready documentation. 
• Excellent communicator with a service-oriented, empathetic approach; able to explain complex topics clearly and maintain discretion with PHI/PII. 
• Strong Excel/reporting skills and comfort working with HR/benefits data (pivot tables, VLOOKUP/XLOOKUP, data validation, and trend reporting). 
• Process and continuous improvement mindset with experience developing SOPs, improving workflows, and meeting service-level expectations.