Sr. Benefits & Leave Administrator chez MPOWERHealth

HaloMD

Who We Are: 

HaloMD specializes in Independent Dispute Resolution (IDR) through The No Surprises Act and state regulations for out-of-network healthcare providers, leveraging advanced technology and deep industry expertise to secure optimized reimbursements.

Job Summary:
The Benefits & Leave Administrator ensures accurate, timely administration of HaloMD’s health & welfare benefit plans and manages end-to-end leave processes (FMLA, ADA, STD, LTD, state leaves). This role serves as the primary employee contact for benefits and leaves, partners with vendors/carriers, maintains compliance (ACA, COBRA, ERISA, HIPAA), and coordinates closely with Payroll, HRBPs, and managers to deliver a high-touch employee experience.

Essential Job Duties and Responsibilities:

• Administer day-to-day benefits (medical, dental, vision, HSA/FSA, life/AD&D, disability, EAP, retirement),
  including new hire enrollment, life events, and terminations.
• Conduct eligibility audits; reconcile monthly invoices and resolve discrepancies with carriers/vendors.
• Lead/open enrollment execution: project plan, testing, communications, employee support, and file/data
  validation.
• Manage COBRA events (in-house or through TPA) and ensure timely notices.
• Maintain plan documents/SPDs/SMMs and partner with broker/carriers on renewals and plan changes.
• Track and report ACA data; support 1095-C/1094-C, 5500, nondiscrimination testing, and other required filings.
• Own the leave lifecycle: intake, eligibility, designation, required notices, tracking, and return-to-work.
• Coordinate STD/LTD claims with carriers and align leave pay with payroll calendars; track benefit premium
  arrears during unpaid leaves.
• Facilitate the ADA interactive process (medical documentation, reasonable accommodations, periodic
  reviews) and document outcomes.
• Partner with managers/HRBPs on scheduling, coverage plans, and communication cadence while protecting
  confidentiality.
• Maintain accurate leave records in HCM and prepare status reports/metrics (open cases, upcoming RTWs,
  expirations).
• Ensure compliance with ACA, ERISA, HIPAA, COBRA, FMLA, ADA, and applicable state leave laws; monitor
  regulatory changes and update processes/policies accordingly.
• Maintain SOPs, workflows, templates, and employee communications for benefits and leaves.
• Prepare routine dashboards: enrollment counts, OE completion, invoice variances, open leave cases, RTW
  timelines, and SLA adherence.
• Process enrollments/changes through the HCM/benefits platform (e.g., UKG/Workday/Oracle) and validate
  carrier feeds (EDI).
• Provide high-touch employee support via ticketing/email/office hours; resolve complex issues and escalate to
  carriers/broker when needed.
• Develop concise guides/FAQs and deliver brief trainings for managers and employees (OE, life events, leave
  basics).

Experience & Education:

• Bachelor’s degree or equivalent experience in HR/Benefits or related field.
• 5+ years of hands-on benefits administration and leave management in a multi-state environment;
  healthcare or self-funded plan experience preferred.
• Experience working with a modern HCM/benefits platform (e.g., UKG, Workday, Oracle) required.
• Strong knowledge of ACA, ERISA, HIPAA, COBRA, FMLA, ADA and related state leave laws.
• Detail-oriented with excellent follow-through; skilled in invoice reconciliation and data accuracy.
• Clear, compassionate communicator with strong customer-service mindset and discretion with PHI/PII.
• Solid Excel/reporting skills; ability to manage multiple priorities and deadlines.
• Process-minded: creates SOPs, improves workflows, and meets SLAs.