Benefits and Leave Analyst, Project Lead

Highland Hospital•Rochester, NY

26d

About The Position

This position is responsible for the coordination of Highland Hospital’s Benefits and Leave Administration processes and procedures. Under the supervision of the Benefits Manager, the Benefits and Leave Analyst, Project Lead have responsibility for administering and communicating Highland Hospital’s health, welfare and leave programs in accordance with government regulations, plan documents and Highland’s policies and procedures, but is not limited to the coordination and compliance regarding Workers’ Compensation, PFL, and Disability for Highland Hospital as well as The Highlands Living Center, The Highland’s at Pittsford and The Highlands at Brighton.

Requirements

Minimum of three years of working experience in Benefits and Leave Administration (Medical, Dental, Vision, COBRA, EAP, Voluntary Plans, Life and Disability DBL/PFL, FMLA, Worker’s Compensation)
Ability to utilize critical thinking skills in various situations.
Understanding of the processing of Medical, Dental, Vision, COBRA, EAP, Voluntary Plans, Life and Disability, workers’ compensation claims including NYS Workers’ Compensation Law, NYS Disability and FMLA preferred.
Knowledge of medical terminology, work-related injuries and occupational diseases preferred.
Computer experience, especially in Internet claims databases, to be able to utilize and generate reports.
Must have a working knowledge of Excel formulas and spreadsheets.
Ability to communicate effectively, both orally and in writing.
Ability to manage workloads and meet regular deadlines.

Nice To Haves

CEBS preferred
Understanding of the processing of Medical, Dental, Vision, COBRA, EAP, Voluntary Plans, Life and Disability DBL/PFL, FMLA, Worker’s Compensation)
Knowledge of medical terminology, work-related injuries and occupational diseases preferred.

Responsibilities

Administers health and welfare benefits, including medical and dental insurance, Health Savings Accounts (HSAs), Flexible Spending Accounts (FSAs), life insurance, long-term disability and voluntary benefits throughout the employment life cycle.
Assists employees with their benefits questions and provides transactional support.
Research benefits issues, identifies root causes and corrective action and provides timely resolutions to employees.
Processes enrollment system transactions according to Highland’s and vendor’s policies and procedures.
Tracks Qualifying Life Event (QLE) documentation and processes enrollment changes based on Highland’s policies and compliance with ERISA and HIPAA regulations.
Administers voluntary life insurance Evidence of Insurability (EOI) process.
Tracks Qualified Medical Child Support Orders (QMCSOs) and processes enrollments, disenrollments and notifications to required agencies.
Facilitates annual Dependent Care FSA non-discrimination testing.
Assists Benefits Manager with annual Open Enrollment activities, including enrollment system preparation, coordination with carriers/vendors, employee meetings and mailings and post-open enrollment audits.
Present benefit materials to new employees at the New Employee Orientation session
Investigate, monitor and assist in determining compensability of Workers’ Compensation claims.
Identifies claims as “lost time” or “medical only” under Section 110 of the WCL.
Receives notice of work-related injury and/or illness and completes appropriate paperwork for third party administrator.
Research laws/regulations or relevant subject matter and responds to inquiries.
Advise employees regarding the claims process and policy.
In collaboration with third party administrator to assure that procedures for workers’ compensation claims are carried out.
Coordinates the disability process including all communication with employees and managers, answer questions and advice on FMLA and payments .
Works closely with carrier and maintains relationship.
Coordinates the FMLA process including all communication between Highland and employees regarding a FMLA.
Is responsible for providing employees with the documentation on a timely basis and tracking in order to meet deadlines.
Responsible for determining if the employee meets or does not meet the eligibility requirements and providing proper notification of so.
Tracking of an employee’s FMLA, notifications of when FMLA exhausts, and is responsible to seek medical certifications when necessary.
Provide back-up coverage for Benefits Manager to include being the daily operational leader
Serves as the primary resource for staff seeking guidance on project implementation, processes, and event execution.
Serves as the subject matter expert and first point of contact for questions.
Assigns and coordinates project tasks in collaboration with management, monitors progress, and helps ensure deadlines and quality standards are met.