The Benefits Specialist is responsible for administering and managing employee benefits programs, including health insurance, retirement plans, leave policies, wellness programs, and other company-offered benefits. This role ensures compliance with relevant laws and regulations, supports employee inquiries, and provides education and guidance to staff regarding their benefits options. Manages coordination of leave of absence program, worker’s compensation and ensures compliance with federal and state payroll and benefits, FMLA standards and provides essential support to the Human Resources department.  Collaboration with payroll on employee benefit deductions and reporting guidelines.

 

Essential Duties and Responsibilities:

 

Payroll Functions:

1. Transmit worker’s compensations payments and provide back up for annual audit.
2. Reconcile paid time off, benefits liability accounts and accrued payroll monthly.
3. Serve as the audit liaison and prepare documentation in support of external and internal audits.
4. Perform work in collaboration with key stakeholders.
5. Act as a resource to others on Ad hoc projects.
6. Work cross-functionally with management and other departments to improve workflow.
7. Document procedures as needed.
8. Provide the required information on time and with a high degree of accuracy and transparency.
9. Serves as the primary point of contact for employee benefits and payroll related inquiries.
10. Performs other duties as assigned by leadership.

 

Benefits Administration:

 

1. Administer and manage employee benefits programs, including health, dental, vision, disability, life insurance, and retirement plans.
2. Handle the enrollment, changes, and terminations of employee benefits.
3. Assist employees with benefit-related questions and concerns.
4. Process benefits-related paperwork, ensuring accurate and timely completion.
5. Ensure all benefit plans comply with federal and state regulations.
6. Coordinate the annual open enrollment process, including communication materials, presentation, and system updates.
7. Upload to retirement portals after payroll submission.
8. Act as liaison with 403(b) plan record-keepers to ensure timely and accurate administration of enrollment, participant deferrals, employer contribution timing, regulation changes and monitoring of compliance.
9. Manages COBRA, FMLA and other leave programs.
10. Process benefits enrollments, changes, and terminations in the HRIS system.

 

Compliance and Reporting:

1. Ensure compliance with federal, state, and local regulations (e.g., ACA, ERISA, HIPAA, FMLA, COBRA).
2. Prepare and submit required reports to government agencies and internal stakeholders.
3. Maintain accurate records of employee benefits and ensure data integrity
4. Conduct benefits audits to ensure accuracy and compliance.
5. Assist in the development and implementation of benefits, payroll policies and procedures.
6. Stay current on industry trends and regulatory changes affecting employee benefits.

 

Communication and Support:

 

1. Provide clear communication to employees about available benefits, eligibility, and enrollment processes.
2. Conduct benefits orientations for new hires and ongoing education sessions for existing employees.
3. Provides support to employees during the benefits enrollment process
4. Develop and distribute benefits-related communication materials (e.g., newsletters, emails, and FAQs).
5. Assist in the preparation and distribution of benefits statements and other communication materials.

 

 

Vendor Management:

 

1. Coordinate with benefits providers to resolve employee issues and ensure the smooth administration of benefit programs.
2. Participate in the evaluation and selection of benefits vendors and programs.
3. Assist with annual benefits renewals, negotiations, and open enrollment processes.

 

 

 

Benefits Analysis and Improvement:

 

1. Analyze benefits data to identify trends, make recommendations for improvements, and support cost-control measures.
2. Assist in benchmarking studies to ensure the company's benefits offerings are competitive within the industry.

 

Leave Administration:

 

1. Manage leave of absence requests, including FMLA, disability, and other leave programs.
2. Track and maintain accurate leave records, ensuring compliance with applicable regulations and company policies.

Worker’s Compensation:

 

1. Manage the full cycle of workers' compensation claims, including reporting, investigation, processing, and follow-up.
2.  Serve as the primary point of contact for injured employees, insurance carriers, medical providers, and attorneys.
3. Ensure timely and accurate reporting of injuries and claims to insurance carriers and relevant state agencies.

 

 

Other Responsibilities:

1. Manages onboarding process and new hire orientation.

1. Manages off boarding process.
2. Participate in benefits surveys and benchmarking activities.
3. Assist in the evaluation and selection of benefits providers and vendors.
4. Provide support for the Human Resources projects and initiatives as needed.
5. Maintain confidentiality of employee information and adhere to data privacy regulations.
6. Perform other duties as assigned by Chief Financial Officer and Human Resources Manager.

 

 

Minimum Qualifications:

 

1. Bachelor’s degree in human resources, Business Administration, or related field (or equivalent experience).
2.  2-4 years of experience in benefits administration or human resources.
3. Knowledge of benefits laws and regulations (ACA, ERISA, HIPAA, FMLA, COBRA, etc.).
4. Experience in managing Worker’s Compensation.
5. Proficiency in HRIS and benefits administration systems.

 

Preferred:

1. Dayforce HRIS system.
2. Experience serving a multinational, multicultural population.
3. Familiarity with community health clinics and/or Indian Health Clinics.

4. FQHC, grant funding environment.

 

Special Conditions of Employment:

 

1. CPR Certification in good standing

 

 

Knowledge, Skills, and Abilities:

1. Ability to work independently and multi-task, with a strong attention to detail.

1. Ability to communicate effectively, excellent verbal and written communication skills.
2. Excellent time management skills.
3. Excellent organizational skills and attention to detail.
4. Ability to maintain confidentiality and meticulous records.
5. Adaptability and flexibility.
6. Effective interpersonal skills, analytical and problem-solving skills.
7. Able to deal effectively with a diversity of individuals.
8. Ability to handle sensitive information with confidentiality and professionalism.
9. Demonstrated proficiency in Microsoft Suite or related programs. Ability to learn other accounting software systems.
10. Strong teamwork and collaboration skills
11. Ability to manage multiple tasks and deadlines

 

 

 

   Physical and Mental Requirements:

 

1. Able to lift/move up to 10 pounds, move from place to place.
2. Able to sit at a desk and work on a computer for prolonged periods.
3. Able to stand, bend and reach for prolonged periods.
4. Ability to do math, organize and prioritize workload, work effectively and efficiently under stress.
5. Ability to proficiently read, write, speak, and understand English.

 

 

 

Customer Service:

 

1. Strong communication and interpersonal skills
2. Ability to establish and maintain cooperative working relationships with all during the course of work.
3. Actively supports, promotes, and works to fulfill the Mission, Vision, and core values of SDAIHC.
4. Provides excellent internal and external customer service.
5. Demonstrates SDAIHC’s Standards of Customer Service Behavior: Compassion, Attitude, Communication, Appearance, Sense of Ownership, and Teamwork.
6. Participates in on-going customer service training.
7. In every action, seeks to promote SDAIHC as a top service organization.

 

 

Quality Management:

 

1. Contribute to the success of the organization by participating in quality improvement activities.
2. Comply with all SDAIHC policies and procedures and proactively participates in the implementation of new initiatives.
3. Participate and ensures continuous quality improvement process as directed by clinic leadership.  

 

 

Safety:

 

1. Ensures regulatory compliance and adherence with policies and procedures related to safe work practices.
2. Participate in infection prevention through appropriate use of infection control measures during patient treatment and patient interactions.
3. Ensure compliance with regulatory requirements for maintaining physical spaces, equipment, and supplies.  
4. Uses all appropriate equipment and/or tools to ensure workplace safety. 
5. Immediately reports unsafe working conditions.  

 

           

 

 

Privacy/Compliance:

           

1. Maintains privacy and security of all patients, employee, and volunteer information and access to such information. Such information is accessed on a need-to-know basis for business purposes only. 
2. Complies with all regulations regarding corporate integrity and security obligations. Reports on unethical, fraudulent, or unlawful behavior or activity.
3. Upholds strict ethical standards.

 

 

Flexibility:

 

1. Available for all shifts and, when required, able to work evenings and weekends.

 

  

 

 

 

 

Disclaimer

Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. This description reflects management’s assignment of essential functions; it does not proscribe or restrict the tasks that may be assigned. This job description is subject to change at any time.

 

Preference is given to qualified American Indian/Alaskan Natives in accordance with the American Indian Preference Act (Title 25, U.S. Code Section 472, 473 and 473a). In other than the above, the San Diego American Indian Health Center, is an equal opportunity employer.

 

 

 

Acknowledgement

 

San Diego American Indian Health Center is an Equal Opportunity Employer. We encourage applications from all individuals regardless of race, religion, color, sex, pregnancy, national origin, sexual orientation, gender identity, gender expression, ancestry, age, marital status, physical or mental disability or any other protected class, political affiliation, or belief.

 

Preference is given to qualified American Indian/Alaskan Natives in accordance with the American Indian Preference Act (Title 25, U.S. Code Section 472, 473 and 473a). In other than the above, the San Diego American Indian Health Center, is an equal opportunity employer.

 

San Diego American Indian Health Center is an Equal Opportunity Employer. We encourage applications from all individuals regardless of race, religion, color, sex, pregnancy, national origin, sexual orientation, gender identity, gender expression, ancestry, age, marital status, physical or mental disability or any other protected class, political affiliation, or belief.