Senior Benefits Administrator

The company only initiates contact with candidates via email from an official the company email address (@ the company , @ patientpop.com , or @ kareo.com ) or through our applicant tracking system, Greenhouse. We will only ask you to provide sensitive personal information through our official application portal — not via social media or text message. We do not conduct interviews via instant messaging.

About the Role

We are seeking an experienced and analytical Senior Benefits Administrator to oversee the day-to-day administration and strategic alignment of our health and welfare plans. Reporting directly to the HR Operations Director, this role plays a pivotal part in managing our self-insured medical plan, monitoring plan performance, managing Third-Party Administrator (TPA) relationships, and ensuring compliance across all health and welfare offerings (medical, dental, vision, life, disability, 401K and wellness).

The ideal candidate possesses deep expertise in ERISA, HIPAA, and ACA compliance, strong data analytics capabilities to evaluate claim trends, and exceptional employee communication skills to deliver a seamless experience.

Your Area of Focus

Self-Insured Plan Oversight & Financial Management

• Claims Analysis & Tracking: Monitor ongoing medical and prescription drug claims performance; identify trends, high-cost claimants, and cost-driver patterns in partnership with plan actuaries and brokers.

• Stop-Loss Administration: Coordinate stop-loss policy renewals, track claims reaching individual/aggregate stop-loss thresholds, and submit reimbursement filings to carriers.

• TPA & Vendor Governance: Oversee relationships with Third-Party Administrators (TPAs), Pharmacy Benefit Managers (PBMs), and Benefits broker and carriers. Ensure operational execution according to SLAs.

• Funding & Reconciliations: Partner with Payroll and Accounting to manage weekly/monthly billing, claims funding requests, reserve requirements (IBNR tracking), and employee contribution and invoice reconciliations.

Health & Welfare Plan Administration

• Open Enrollment: Lead the annual Open Enrollment process, including system updates, open enrollment communications, employee informational sessions, and post-enrollment audits.

• Life Events & Ongoing Administration: Manage day-to-day enrollment changes, qualifying life events (QLEs), dependent eligibility verifications, and COBRA processing.

• Disability & Leave Coordination: Support short-term/long-term disability programs and align benefit premiums during active FMLA/LOA periods.

Compliance & Governance

• Regulatory Reporting: Ensure strict compliance with federal and state regulations, including ERISA, ACA (1094/1095 reporting), HIPAA, COBRA, and FMLA.

• Plan Documentation: Maintain updated Summary Plan Descriptions (SPDs), Summaries of Benefits and Coverage (SBCs), Plan Documents, and Form 5500 filings.

• Nondiscrimination Testing: Coordinate annual 105(h) and Section 125 nondiscrimination testing with third-party compliance specialists.

• Annual Benefits Audits: Lead annual 401K audit and execute dependent eligibility and enrollment audits throughout the year.

Employee Experience & Communications

• Escalated Claims Support: Act as the primary point of contact for complex, escalated employee claims issues, serving as an advocate while maintaining plan governance.

• Benefits Communication: Draft clear, accessible employee communications explaining self-insured plan features, cost-saving tools (e.g., telehealth, centers of excellence), and wellness incentive initiatives.

Your Professional Qualifications

Education & Experience

• Bachelor’s Degree in Human Resources, Business Administration, Finance, or a related field (or equivalent practical experience).

• 5 years of direct experience dedicated to health & welfare plan administration.

• Demonstrated experience managing self-insured / self-funded medical plans, including working with stop-loss insurance, TPAs, and PBMs.

• Professional Certifications (Preferred): CEBS (Certified Employee Benefit Specialist), SHRM-CP/SHRM-SCP, or PHR/SPHR.

Technical & Analytical Skills

• HRIS Proficiency: Experience administering benefits using Workday.

• Data & Excel Mastery: Advanced skills in MS Excel (Pivot Tables, VLOOKUP/XLOOKUP, data modeling) to analyze large sets of claims and census data.

• Regulatory Depth: Deep functional knowledge of ERISA, ACA, HIPAA, COBRA, and IRS Section 125 rules.

#LI-SS1 #LI-Remote

We are dedicated to attracting and retaining top talent with competitive and fair compensation. For this position, this range reflects our Zone 1 (National Average) pay band. Your specific compensation is thoughtfully determined by your experience, qualifications, the specific requirements of the role, and your Geo Zone. Our geo-zone system ensures your pay is competitive for your location, recognizing varying costs of labor across regions.

Our four geo zones are designed to reflect this

Zone 1: National Average

Zone 2: Moderately Higher Cost Regions

Zone 3: High-Cost Regions

Zone 4: Lower-Cost Regions

Beyond base compensation, the company offers eligible employees the opportunity for variable pay and a robust benefits package, reflecting our commitment to your overall well-being. In compliance with California pay transparency laws, the specific compensation range applicable to your Geo Zone will be shared during your initial talent screen.

Zone 1 (National Average)

$90,000 — $103,000 USD

About the company

The company is the only all-in-one EHR+ platform built exclusively for independent healthcare practices. Designed to replace the clunky, fragmented tools built for corporate systems, the company connects EHR software, billing, automation, telehealth solution, and marketing — so providers can spend less time on admin and more time with patients. More than 42,000 private practices trust the company to streamline operations, increase revenue, and reduce burnout — helping clinicians leave work on time and rediscover their purpose. Learn more at  [link for members] .

Our Values

Start with the Customer

We get to know our customers - and their patients - and look at the world through their lens.

Keep It Simple

Healthcare is too complex. We aim to simplify it for everyone.

Stay Entrepreneurial

We reject the status quo and solve problems with creativity, perseverance, and a bias to action.

Better Together

We are diverse, humble, and collaborative. We put the team first and win together.

Celebrate Success

Life is short and joy is underrated. We take time to have fun and celebrate success.

Perks & Benefits

United States: In addition to our healthcare benefits, we also offer amazing perks! Need work from home basics? We offer a discount through Dell! We also offer a number of resources to help you keep your mind and body healthy. Check out Gympass for a great workout, or TelusEmployee Assistance Program to find mental health resources, along with other resources for everyday occurrences.

Costa Rica: To assist with all of life’s needs, the company also offers a wellness and childcare subsidy and a University/Education discount! We also offer a number of resources to help you keep your mind and body healthy. Check out Gympass for access to health and fitness apps, or Telus Employee Assistance Program to find mental health resources, along with other resources for everyday occurrences.

Compliance & Privacy Disclosures

NOTE: the company is an equal opportunity employer. All applicants will be considered for employment without attention to age, race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

California residents who apply or are recruited for a job with us: please carefully review our California-specific Privacy Notice under the California Consumer Protection Act here: [link for members]

If you would like to report a fraudulent the company job posting, please contact us at  [link for members]  and consider reporting your experience to the FBI's Internet Crime Complaint Center or the Better Business Bureau to help keep others safe online, too.

As part of our commitment to a fair and efficient hiring process, the company utilizes Greenhouse Notetaker, Greenhouse's native interview intelligence tool, for our phone and video screenings. This technology records and transcribes interviews to help us ensure consistency, reduce bias, and make more informed hiring decisions. By applying for this position, you acknowledge that your interview may be recorded.