Employee Benefits Specialist

Employee Benefits Specialist

Provides proactive support to the HR functions for the units assigned to promote our culture of caring and leadership. Participates in a variety of HR projects and initiatives including Employee Relations, HR Audits and Compliance, and obtaining and analyzing HR data to provide the support needed to help Operations meet goals and objectives. Talent Management activities including recruiting, onboarding, and Training. Total Rewards activities including Benefits Management, Work-Life Balance programs, Compensation administration, and Reward Program implementation. Provides backup for HR Department members as needed.

Education, Licensure, and Experience required for the position include : Four-year college degree in Human Resources.

Physical requirements to perform essential functions of the job include : Regularly required to lift 10 lbs. Must be able to lift a minimum of 15 lbs. Must be able to pull a minimum of 10 lbs. Must be able to squat, kneel, crawl, crouch, climb, and stoop. Must be able to regularly use hands to finger, handle, or feel objects, tools, or controls. Required to regularly stand and walk. Must be able to demonstrate proficiency in CPR from the floor level requiring to work on hands, knees, bending, standing and lifting. Vision requirements include close vision, distance vision, and peripheral vision. Must be able to talk and hear.

Duties and Responsibilities

• Serve as tier-2 / tier-3 escalation for complex benefits inquiries (eligibility, coverage, claims guidance, life events, QMCSO, EOI, coordination of benefits), ensuring timely, accurate resolution and excellent service.
• Educate employees and leaders on plan features, eligibility rules, waiting periods, cost, and HCM self-service navigation; create and maintain FAQs and quick-reference guides.
• Track cases to closure, monitor SLAs / CSAT, identify themes, and recommend fixes (training, comms, configuration).
• Process and audit new hire enrollments, life events, returns from leave, and terminations; validate effective dates and documentation.
• Run routine eligibility and dependent verification audits; correct errors and coach end-users to prevent recurrences.
• Own routine HCM / benefits data audits (sampling, reconciliation to carrier files, arrears review); partner with Payroll on deduction accuracy and retroactivity.
• Lead OE workstreams : rate / table audits, event configuration testing, QA checklist execution, data validation, blackout coordination, and post-OE reconciliation.
• Produce OE guides, plan comparisons, and comms cadence; facilitate employee info sessions (live / virtual) and support leaders with toolkits.
• Track OE completion and intervene with targeted outreach to non-responders.
• Serve as daily liaison to carriers / TPAs for eligibility, escalated claims, and service issues; log and drive resolutions.
• Reconcile monthly carrier invoices to payroll deductions / eligibility; research variances, prepare corrections, and submit adjustments for approval.
• Monitor scheduled EDI / file feeds; resolve rejects and timing mismatches with HRIS and vendors; document root causes and preventive actions.
• Support ERISA / Section 125 administration, SBCs / SMMs / SPDs distribution, HIPAA privacy practices, and ACA reporting data quality (1094 / 1095).
• Coordinate COBRA events via vendor and audit files for accuracy; ensure timely notices through the vendor.
• Maintain SOPs, desk guides, and audit trails; assist with internal audits, external audits, and broker / carrier stewardship reviews.
• Produce recurring and ad hoc reports (enrollment, participation, arrears, OE metrics, appeals / escalations) for Total Rewards and Finance.
• Partner with HRIS on configuration / testing and with Payroll on complex deduction issues, arrears, and refunds.
• Support acquisitions by coordinating Day-1 readiness, employee communications, enrollment timelines, data onboarding, and blackout plans.
• Identify and implement process improvements to enhance accuracy, efficiency, and employee experience (forms, automation, self-service content).
• Perform other duties as assigned.

Supervisory Responsibilities

This position has no supervisor responsibilities.

Minimum Qualifications

Physical Demands and Work Environment

RHA is an Equal Employment Opportunity Employer, prohibits discrimination based on the following protected categories : race, creed, color, national origin, nationality, ancestry, age, sex / gender, marital status, civil status, domestic partnership status, familial status, religion, affectional or sexual orientation, gender identity or expression, atypical hereditary cellular or blood trait, genetic information, liability for service in the Armed Forces of the United States, or disability.

Pre-employment screening :

We offer the following benefits to employees :

EEO Statement RHA is an equal opportunity employer. In addition, we provide reasonable accommodation to qualified employees who have protected disabilities to the extent required by applicable laws, regulations, and ordinances. If you are an individual with a disability and need a reasonable accommodation to participate in the application process, please contact our solutions center.

About RHA :

At RHA Health Services, we help individuals with intellectual and developmental disabilities, mental health and / or substance use needs live their best lives. Our mission is to provide a safe and healthy environment while creating opportunities for personal outcomes.

For over 30 years, the people we serve and support have remained at the very center of everything we do. RHA currently provides services in North Carolina, Georgia, Pennsylvania, Tennessee, and New Jersey.

If you are ready to make a difference in the lives of people we serve and support apply to join the team today.