04 oct
|
Transformcap
|
Tijuana
04 oct
Transformcap
Tijuana
Tebra only initiates contact with candidates via email from an official Tebra email address (@tebra.com, @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 adecuado 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 reconci
📌 Senior Benefits Administrator (Tijuana)
🏢 Transformcap
📍 Tijuana