Note: The job is a remote job and is open to candidates in USA. Zenith American Solutions, Inc. is the largest independent Third Party Administrator in the United States, and they are seeking a Benefits Billing & Operations Analyst. The role involves overseeing benefit billing operations, ensuring data integrity, conducting audits, and collaborating with various stakeholders to effectively administer employee benefit programs.
Responsibilities
- Develop standardized audit procedures and reconciliation methodologies
- Perform comprehensive audits of participant eligibility, employer contribution records, premium invoices, carrier billings, payroll deductions, trust fund transactions, and vendor invoices to ensure financial accuracy, regulatory compliance, proper plan administration, and timely resolution of discrepancies
- Analyze large volumes of benefits, billing, enrollment, eligibility, and financial data to identify trends, anomalies, operational risks, and opportunities for automation and continuous process improvement
- Conduct complex financial reconciliations between employer contributions, trust accounting records, payroll deductions, carrier invoices, participant eligibility, and billing systems. Investigate discrepancies, determine root cause, and implement corrective actions to ensure financial integrity
- Manage benefits-related audits, including trust benefit audits, monthly employee deduction audits, 401(k) audits
- Review and approve complex billing adjustments, retroactive premium corrections, eligibility determinations, and reconciliation activities
- Administer and manage group health, dental, vision, life, disability, and 401(k), including complex enrollments, life events, and compliance reporting
- Process benefits enrollments, changes, and terminations
- Respond to employee inquiries regarding benefits eligibility, plan provisions, claims and coverage issues. Resolve escalated issues as needed
- Prepare and maintain documentation related to benefit plans and leave administration in compliance with applicable federal and state regulations
- Support benefits renewal processes with updates to benefits summaries, Workday benefits portal setup
- Analyze employee utilization trends, claims experience, and participant feedback to recommend enhancements to benefit programs
- Analyze and interpret plan documents, collective bargaining agreements, administrative policies, and eligibility provisions to ensure accurate trust billing administration
- Exercise independent judgment in resolving complex participant, employer, and vendor billing issues
- Develop, implement, and maintain operational workflows, process controls, and billing procedures that improve efficiency, strengthen internal controls, and ensure compliance with established service standards and due dates. Serve as a subject matter expert (SME) on benefit billing processes, eligibility rules, and trust fund administration
- Performs other duties as assigned
Skills
- Bachelor's degree in business administration, Human Resources, Accounting, Finance, or a related field; equivalent combination of education and experience may be considered
- 3+ years of progressively responsible experience in employee benefits administration, trust fund administration, accounting, finance, payroll, or related field
- Demonstrated experience performing financial reconciliations, operational audits, or data integrity reviews
- Strong understanding of federal and state regulations governing benefits, including ERISA, HIPAA, COBRA, ACA, and FMLA
- Experience administering complex employee benefit plans, multiemployer plans, or Taft-Hartley trust funds preferred
- Demonstrated ability to make recommendations that influence operational, financial, and administrative decisions
- Advanced Microsoft Excel skills including Pivot Tables, VLOOKUP, formulas, and data validation
- Excellent communication, problem-solving and organizational and analytical skills
- Highly organized, self-motivated, and detail orientated
- Professional certification, such as Certified Employee Benefits Specialist (CEBS) or PHR/SPHR
- Experience with internal audit methodologies and financial reconciliation processes
- Experience developing operational procedures, internal controls, and compliance programs
- Experience supporting SOC audits, ERISA audits, DOL audits, IRS audits, or external financial audits
- Demonstrated ability to make recommendations that influence operational, financial, and administrative decisions
Benefits
- Health, vision, and dental coverage
- A retirement savings 401(k) plan with company match
- Paid time off (PTO)
- Great opportunities for growth
- Much, much more!
Company Overview