Key Responsibilities and Required Skills for Benefits Specialist

🎯 Role Definition

The Benefits Specialist is a hands‑on HR professional who owns day‑to‑day benefits administration and employee advocacy around health, welfare and retirement programs. This role manages open enrollment, eligibility and life‑event processing, vendor relationships, benefits communications, and ensures compliance with federal and state regulations (ACA, ERISA, HIPAA, COBRA, FMLA). The Benefits Specialist partners closely with Payroll, HRBP/Generalists, and Finance to maintain accurate benefits records, reconcile invoices, and deliver clear, timely guidance to employees throughout the benefits lifecycle.

📈 Career Progression

Typical Career Path

Entry Point From:

HR Coordinator / HR Administrator with 1–2 years of generalist experience
Benefits Administrator or Benefits Analyst
Payroll Specialist or HRIS Analyst transitioning into benefits

Advancement To:

Benefits Manager / Senior Benefits Specialist
Total Rewards Manager or Compensation & Benefits Manager
Director of Human Resources or Head of Total Rewards

Lateral Moves:

Total Rewards Analyst / Specialist
Payroll Coordinator / Payroll Manager
HRIS Analyst (benefits specialty)

Core Responsibilities

Primary Functions

Manage the full lifecycle of employee benefits administration for medical, dental, vision, life, disability, EAP, and voluntary products — including new hire enrollments, qualifying life event changes, plan terminations, and offboarding processes — ensuring timely, accurate changes in the HRIS and carrier systems.
Lead annual open enrollment planning and execution: coordinate timelines, prepare communication campaigns, update plan materials, host virtual/in-person enrollment sessions, and process enrollment changes and waivers.
Serve as the primary benefits point of contact for employees and managers: answer benefits-related questions, troubleshoot claims and coverage issues, provide counseling on plan design/options, and escalate carrier disputes when needed.
Administer COBRA and COBRA-like state continuation programs: prepare required notices, monitor eligibility timelines, maintain records, and coordinate timely election and premium processing.
Execute ACA compliance responsibilities, including employee tracking, affordability analysis, measurement period administration, and preparing or supporting generation of 1095-C forms for annual reporting.
Administer leave-of-absence programs including FMLA, short-term and long-term disability coordination, working with leave vendors, tracking leave timelines, and ensuring benefits/eligibility continuity during leaves.
Maintain benefits plan documentation, summary plan descriptions (SPDs), plan documents, and internal SOPs; interpret plan language and communicate key provisions to employees and stakeholders.
Manage relationships with benefits vendors and carriers (medical, dental, vision, 401(k), TPAs, stop-loss, COBRA vendors): coordinate escalations, confirm service levels, negotiate service issues, and conduct quarterly/annual vendor reviews.
Partner with Payroll and Finance to reconcile benefits invoices and vendor remittances, validate premium billing, resolve discrepancies, and ensure accurate benefits deductions and journal entries.
Maintain benefits data integrity within HRIS and carrier portals (Workday, ADP, UltiPro, Benefitfocus, etc.): process data changes, run audits, perform reconciliations, and correct data issues to prevent coverage lapses and payroll errors.
Support retirement plan administration and participant services: coordinate 401(k)/403(b) enrollment, contribution changes, loan and distribution coordination, and vendor communications with recordkeepers and advisors.
Create, review, and deliver clear benefits communications, guides, FAQs, and enrollment materials that improve benefit understanding and participation across a diverse employee population.
Conduct benefit cost analysis, benchmarking, and utilization reporting to support plan design decisions, annual renewal strategy, and budget forecasting; prepare executive summaries for HR leadership.
Lead dependent eligibility audits, verification campaigns, and compliance initiatives to reduce plan leakage and maintain compliance with plan terms and audit requirements.
Support benefits-related audits (internal, carrier audits, retirement plan audits): gather documentation, respond to auditor requests, and implement corrective actions as required.
Coordinate and support benefits-related system implementations, enhancements, or migrations (HRIS, benefits administration platforms, carrier connectivity), including UAT, data mapping, and employee communications.
Process benefit carrier file feeds and transactions (EDI files/APIs): validate inbound/outbound files, troubleshoot errors with vendors, and ensure timely carrier updates.
Monitor legislative and regulatory changes that impact benefits programs (ACA updates, HIPAA rule changes, state mandates) and recommend policy updates or process changes to maintain compliance.
Provide benefits training and onboarding to HR colleagues, hiring managers, and new employees to ensure consistent counseling and accurate routing of employee questions.
Drive continuous improvement projects across benefits processes including automation of manual workflows, standardized templates for communications, and efficiency improvements in enrollment and reconciliation procedures.
Coordinate wellness program administration and vendor relationships, track program participation, and measure outcomes to support employee engagement and health incentives.
Support ad-hoc benefits projects such as M&A integration benefits harmonization, open enrollment strategy redesign, voluntary benefit program launches, and cost-saving initiatives.

Secondary Functions

Assist HR leadership with benefits strategy, plan design recommendations, and total rewards communications that align with talent attraction and retention goals.
Contribute to cross-functional HR technology initiatives by providing benefits subject matter expertise during HRIS and payroll integrations.
Provide basic benefits analytics and dashboards for HR partners using Excel, Power BI, or HRIS reporting tools to support decision making.
Participate in benefits vendor selection processes including RFP coordination, vendor evaluation, and contract review support.
Support international benefits coordination for global employees by liaising with international mobility and outside brokers, where applicable.
Maintain records and run periodic reconciliations to support month-end and quarter-end financial close related to benefits liabilities.

Required Skills & Competencies

Hard Skills (Technical)

Benefits administration (medical, dental, vision, RX, life, disability, voluntary benefits) — demonstrated operational experience administering multiple benefit lines.
HRIS and benefits platforms: proven experience with systems such as Workday, ADP/Workforce Now, UltiPro, Paylocity, BenefitFocus, or Oracle HRMS.
COBRA and ACA compliance: hands-on administration and reporting experience (including 1095-C and measurement period tracking).
Leave administration and FMLA coordination, including vendor-managed leaves and return-to-work processes.
Retirement plan/401(k) administration familiarity and coordination with recordkeepers and TPA.
Vendor management and carrier reconciliation, including invoice review, remittance processing, and dispute resolution.
Strong Excel skills (pivot tables, VLOOKUP/XLOOKUP, data cleanup) and experience preparing benefits reports and dashboards.
Benefits analytics and benchmarking: experience creating utilization reports, cost-per-employee calculations, and renewal analysis.
Benefits communications and benefits education development (benefits guides, enrollment materials, presentations).
Knowledge of ERISA, HIPAA privacy rules, state continuation laws, and other benefits-related regulations.
Experience with EDI/transaction file management between HRIS and carriers (uploads, file monitoring, error resolution).
Project management experience supporting system implementations, vendor migrations, or benefits program launches.

Soft Skills

Exceptional verbal and written communication skills with an employee-centric counseling approach.
High attention to detail and accuracy when handling confidential employee and payroll data.
Strong organizational skills with ability to manage competing priorities and strict timelines (open enrollment, reporting deadlines).
Problem-solving attitude and escalation management to resolve complex coverage or billing issues.
Customer-service orientation and empathy when guiding employees through health and leave events.
Collaborative team player who partners effectively with HRBPs, Payroll, Finance, and external vendors.
Discretion and ability to maintain confidentiality on sensitive benefits and health information.
Change management capability to drive adoption during benefits changes or HRIS implementations.
Analytical mindset with ability to translate data into actionable insights for leadership.
Resilience and adaptability in a fast-paced environment with frequent regulatory changes.

Education & Experience

Educational Background

Minimum Education:

Bachelor's degree in Human Resources, Business Administration, Finance, or related field — or equivalent professional experience (typically 2+ years) in benefits administration.

Preferred Education:

Bachelor’s degree in Human Resources or Business Administration.
Professional certifications such as SHRM-CP, PHR, CEBS, or benefits-specific certifications preferred.

Relevant Fields of Study:

Human Resources
Business Administration / Management
Finance / Accounting
Healthcare Administration

Experience Requirements

Typical Experience Range:

2–5 years of progressive benefits administration experience in a corporate HR or third‑party administration environment.

Preferred:

3–7 years of hands-on benefits experience, including open enrollment ownership, ACA/COBRA administration, HRIS benefits data management, and vendor oversight. Experience with midsize to large employer benefits programs, 401(k) coordination, and benefits project management is highly desirable.