OVERALL DESCRIPTION

Senior Employee Benefits Specialist is responsible for the administration and strategic support of SEPTA's retiree and employee benefits programs. They serve as a vital link between employees and insurance providers, ensuring that benefits are clearly explained, accessible, and compliant with all federal and state regulations. Coordinates the Authority's COBRA program and conducts eligibility audits to ensure that participants are enrolled in the proper plans and are making appropriate contributions. The Employee Benefits Specialist will ensure proper and timely delivery of benefits and issue resolution for participants.

SPECIFIC RESPONSIBILITIES

1. Administer all COBRA functions including enrollment, eligibility, termination, age­out, and all other COBRA related events and functions.
2. Ensure adherence to federal and state laws, including but not limited to ACA, FMLA, and HIPAA.
3. Presents at new employee orientations as scheduled, explaining benefit options, assisting the new employee with enrollment and participating in annual enrollment sessions.
4. Resolves benefits-related claims, inquiries, and complaints.
5. Partners with vendors, consultants, and internal stakeholders to ensure smooth planning and operations.
6. Assists with annual renewals, audits, and compliance requirements.
7. Supports benefits communications and employee education initiatives.
8. Analyzes and interprets benefits data and provides insights to improve plan effectiveness.
9. Answers complex benefits questions.
10. Conducts medical and prescription (and other benefit) eligibility audits, follows up with corrections, and communicates changes to participants and vendors.
11. Conducts dependent audits, obtains missing data, and enters them in mainframe. Follows up with non-responsive employees.
12. Reviews and follows up on prescription drug rebate audits.
13. Assists with the annual Form 1095-C production and distribution.
14. Comply with all Authority and departmental safety and security policies and procedures as well as all applicable job safety responsibilities. Reports any safety concerns, compromises or hazards affecting operations, the public, self and/or other employees. Responsible for personal safety and is encouraged to promote the safety of others.
15. Performs other duties as assigned.

QUALIFICATIONS AND EXPERIENCE

• Bachelor's degree in human resources, business administration, or finance preferred with a minimum of three (3) years of experience in employee benefits administration/analysis or related field of HR.
• Experience with COBRA, HR Administration, auditing, vendor relations, interpreting employee benefits contracts provisions, medical benefits, and regulatory compliance including but not limited to HIPAA, FMLA, ACA.
• Must have excellent written and verbal communication skills.
• Must have excellent customer relations skills.
• Must be able to use critical thinking skills to solve complex problems.
• Familiarity with human resources information systems as an end user is preferred.
• Experience with Microsoft Office suite is required.