Benefits Specialist
Responsive Education Solutions, Lewisville, TX, United States
Position Summary:
The
Benefits Specialist
serves as a lead resource for employee benefit programs across a multi-state network. While serving as an outward-facing advocate for staff in Texas, Arkansas, and Ohio, this individual also functions as a technical lead, overseeing the financial health and compliance of both self-funded and fully-funded insurance models. The role functions as a subject matter expert and assists the Director of Benefits with ensuring accuracy, compliance, and operational efficiency across all benefits platforms. This role requires a unique blend of "high-touch" employee support and "high-tech" data auditing to ensure a seamless benefit experience across multiple states and organizations.
Qualifications: Education: BA degree in Human Resources, Business Administration, or a related field is preferred. Experience: 5+ years of benefits administration, specifically within a multi-site or multi-state organization.
Proven experience managing
self-funded health plans , including understanding of stop-loss, TPA management, and claims fund auditing. Experience with
fully-funded plans
and the annual renewal process. Experience with benefits/payroll integrations and eligibility file feeds.
Knowledge, Skills, and Abilities (KSAs):
Multi-State Expertise:
Knowledge of state-specific leave and retirement laws (e.g., Texas TRS, Ohio STRS/SERS, Arkansas ATRS). Systems Proficiency:
Advanced HRIS skills (e.g., Skyward, Paylocity) and expert-level Google Sheets and/or Excel skills (data comparisons, v-lookups, pivot tables, and auditing large databases) for data auditing. Communication:
Excellent verbal and written skills; ability to translate complex benefit jargon into "employee-friendly" language during Open Enrollment and staff or C-Level presentations. Compliance Mastery:
Advanced knowledge of current and emerging HR regulations across multiple states and territories and the ability to implement proactive compliance frameworks. Data Analysis:
Proficiency in using HR metrics and workforce analytics to drive decision-making and performance monitoring.
Essential Duties and Responsibilities
Multi-State Plan Administration
Primary Lead:
Act as the central point of contact for benefits across affiliated schools and organizations, ensuring equity in plan offerings while respecting local and state mandates. Funding Models:
Monitor the performance of self-funded pools (claims vs. budget) and manage the fixed-cost structures of fully-funded plans. Vendor Partnership:
Participate in quarterly reviews with brokers and carriers to hold vendors accountable for service level agreements (SLAs). Data Auditing & Systems Integrity Carrier Billing:
Conduct monthly "deep-dive" audits of carrier invoices against HRIS enrollment data to ensure 100% accuracy and prevent overpayment. System Optimization:
Serve as the functional lead for the online enrollment portal, ensuring all multi-state plan rules and eligibility groups are correctly programmed. Compliance Reporting:
Lead the preparation of ACA 1095-C filing, PCORI fees, and Form 5500 data collection for all entities and oversee all auditing. Outward-Facing Employee Advocacy Educational Liaison:
Design and deliver multi-state benefit training sessions to educate staff on the value of their total rewards. Escalation Support:
Resolve high-level claims issues or appeals by advocating for employees with TPAs and insurance carriers. New School Integration:
Lead the "Benefits Onboarding" for new schools or states entering the Blue Learning network, ensuring a smooth transition for staff.
Other Duties Travel:
As required to various sites and regional offices. Other Duties:
Perform other duties as assigned by the Executive Director - HR or district leadership. Physical / Environmental Factors: The physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Blue Learning considers applicants for all positions without regard to race, color, national origin, age, religion, sex, marital status, veteran or military status, disability, or any other legally protected status. Blue Learning is an Equal Opportunity Employer.
The
Benefits Specialist
serves as a lead resource for employee benefit programs across a multi-state network. While serving as an outward-facing advocate for staff in Texas, Arkansas, and Ohio, this individual also functions as a technical lead, overseeing the financial health and compliance of both self-funded and fully-funded insurance models. The role functions as a subject matter expert and assists the Director of Benefits with ensuring accuracy, compliance, and operational efficiency across all benefits platforms. This role requires a unique blend of "high-touch" employee support and "high-tech" data auditing to ensure a seamless benefit experience across multiple states and organizations.
Qualifications: Education: BA degree in Human Resources, Business Administration, or a related field is preferred. Experience: 5+ years of benefits administration, specifically within a multi-site or multi-state organization.
Proven experience managing
self-funded health plans , including understanding of stop-loss, TPA management, and claims fund auditing. Experience with
fully-funded plans
and the annual renewal process. Experience with benefits/payroll integrations and eligibility file feeds.
Knowledge, Skills, and Abilities (KSAs):
Multi-State Expertise:
Knowledge of state-specific leave and retirement laws (e.g., Texas TRS, Ohio STRS/SERS, Arkansas ATRS). Systems Proficiency:
Advanced HRIS skills (e.g., Skyward, Paylocity) and expert-level Google Sheets and/or Excel skills (data comparisons, v-lookups, pivot tables, and auditing large databases) for data auditing. Communication:
Excellent verbal and written skills; ability to translate complex benefit jargon into "employee-friendly" language during Open Enrollment and staff or C-Level presentations. Compliance Mastery:
Advanced knowledge of current and emerging HR regulations across multiple states and territories and the ability to implement proactive compliance frameworks. Data Analysis:
Proficiency in using HR metrics and workforce analytics to drive decision-making and performance monitoring.
Essential Duties and Responsibilities
Multi-State Plan Administration
Primary Lead:
Act as the central point of contact for benefits across affiliated schools and organizations, ensuring equity in plan offerings while respecting local and state mandates. Funding Models:
Monitor the performance of self-funded pools (claims vs. budget) and manage the fixed-cost structures of fully-funded plans. Vendor Partnership:
Participate in quarterly reviews with brokers and carriers to hold vendors accountable for service level agreements (SLAs). Data Auditing & Systems Integrity Carrier Billing:
Conduct monthly "deep-dive" audits of carrier invoices against HRIS enrollment data to ensure 100% accuracy and prevent overpayment. System Optimization:
Serve as the functional lead for the online enrollment portal, ensuring all multi-state plan rules and eligibility groups are correctly programmed. Compliance Reporting:
Lead the preparation of ACA 1095-C filing, PCORI fees, and Form 5500 data collection for all entities and oversee all auditing. Outward-Facing Employee Advocacy Educational Liaison:
Design and deliver multi-state benefit training sessions to educate staff on the value of their total rewards. Escalation Support:
Resolve high-level claims issues or appeals by advocating for employees with TPAs and insurance carriers. New School Integration:
Lead the "Benefits Onboarding" for new schools or states entering the Blue Learning network, ensuring a smooth transition for staff.
Other Duties Travel:
As required to various sites and regional offices. Other Duties:
Perform other duties as assigned by the Executive Director - HR or district leadership. Physical / Environmental Factors: The physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Blue Learning considers applicants for all positions without regard to race, color, national origin, age, religion, sex, marital status, veteran or military status, disability, or any other legally protected status. Blue Learning is an Equal Opportunity Employer.