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Key Responsibilities and Required Skills for Group Protection Administrator

💰 $ - $

🎯 Role Definition

The Group Protection Administrator is a client-facing and operations-focused role responsible for the day-to-day administration of group insurance and protection products (group life, disability, critical illness, accidental death & dismemberment, absence management and related voluntary benefits). This role ensures accurate policy documentation, timely enrollment and eligibility processing, claims support, billing reconciliation, and regulatory compliance while delivering high-quality service to clients, brokers and members. Success in this position requires strong insurance domain knowledge, meticulous attention to detail, excellent stakeholder communication and proficiency with benefits administration systems.

Key SEO terms: Group Protection Administrator, group benefits administration, claims adjudication, policy administration, enrollment systems, benefits compliance, client servicing.

📈 Career Progression

Typical Career Path

Entry Point From:

  • Benefits Administrator / Benefits Coordinator
  • Insurance Customer Service Representative
  • Claims Support Specialist

Advancement To:

  • Senior Group Protection Administrator / Senior Benefits Analyst
  • Group Benefits Manager / Benefits Operations Manager
  • Underwriting Analyst or Client Services Lead

Lateral Moves:

  • Claims Analyst / Claims Adjudicator
  • Underwriting Support Specialist
  • Client Relationship Manager (Broker/Employer Services)

Core Responsibilities

Primary Functions

  • Administer day-to-day operations for group protection plans including accurate processing of enrollments, terminations, eligibility changes, beneficiary updates and transfers, ensuring adherence to plan rules and carrier guidelines.
  • Review and validate incoming group plan documentation, master policy contracts, rate schedules and enrollment files to confirm coverage terms and correct set-up in administration systems.
  • Coordinate new business implementations: lead project checklists, map employer plan designs to system configurations, create client and broker implementation timelines, and perform testing to ensure accurate plan launch.
  • Manage end-to-end claims support for group life, disability and other protection products by gathering required documentation, liaising with claims adjudicators, escalating issues, and communicating decisions to clients and members in a timely and empathetic manner.
  • Reconcile monthly and quarterly billing statements and premium invoices; investigate variances against master data, explain adjustments to clients, and coordinate corrections with accounting and carrier partners.
  • Act as primary operational contact for assigned employer groups and brokers, handling inquiries, resolving issues, and delivering proactive account management to improve client satisfaction and retention.
  • Interpret policy provisions, plan booklets and collective bargaining agreements to advise HR and benefits contacts on eligibility, waiting periods, late enrolment rules and porting/continuation options.
  • Maintain and update accurate group master data in benefits administration systems (importing files, batch processing, manual updates) and ensure audit trails are complete for each transaction.
  • Prepare and deliver recurring operational and compliance reporting (enrollment reports, census reconciliations, claims activity summaries, renewal projections) to internal teams and employer clients.
  • Coordinate and support annual renewal activities by compiling plan utilization data, liaising with underwriting, preparing renewal submissions and communicating changes to stakeholders.
  • Process and monitor disability case management handoffs, liaise with third-party case managers and provide documentation to support return-to-work planning and benefit entitlement decisions.
  • Administer beneficiary designations, claim payouts and coordinate with payroll and accounting teams to ensure benefits are paid accurately and in line with plan rules.
  • Ensure regulatory compliance with applicable laws and industry regulations (ERISA, HIPAA, provincial equivalents, anti-money laundering where applicable), and maintain documentation to support audits and regulatory inquiries.
  • Support data quality initiatives through regular audits, reconciliation checks, root cause analysis of exceptions and implementation of corrective actions to reduce recurring issues.
  • Collaborate with IT and vendor partners to troubleshoot and resolve system issues, participate in system upgrades, UAT testing and process automation projects to improve efficiency.
  • Provide guidance and training to internal colleagues and new hires on group protection product features, administration procedures and best practices to ensure consistent service delivery.
  • Manage and prioritize a high-volume caseload while meeting SLAs for response times, processing windows and quality standards; escalate complex or high-risk issues to senior management when required.
  • Support underwriting by preparing experience exhibits, membership trend analyses and claims histories for quoting and renewals.
  • Maintain strong relationships with carrier partners and third-party administrators to ensure service commitments are met and to expedite issue resolution when complex policy matters arise.
  • Handle confidential member information with discretion, applying appropriate privacy and security controls for all documentation and electronic records.
  • Participate in continuous improvement by identifying process inefficiencies, recommending streamlined workflows, and helping implement standardized templates and knowledge base articles.
  • Prepare ad hoc client deliverables such as plan summaries, FAQs, process maps and training materials to assist HR teams and plan administrators in day-to-day operations.

Secondary Functions

  • Support ad-hoc data requests and exploratory data analysis.
  • Contribute to the organization's data strategy and roadmap.
  • Collaborate with business units to translate data needs into engineering requirements.
  • Participate in sprint planning and agile ceremonies within the data engineering team.
  • Assist with periodic vendor performance reviews and SLA scorecard generation to support procurement and vendor management decisions.
  • Provide backup support to payroll, accounting and customer service teams during peak periods or when handling escalated issues.

Required Skills & Competencies

Hard Skills (Technical)

  • Group benefits administration (life, disability, AD&D, critical illness) — configuration and operational processing expertise.
  • Claims support and adjudication workflows for group protection products.
  • Policy interpretation and master policy management, including amendments and endorsements.
  • Experience with benefits administration platforms (examples: HRIS/benefits systems such as Workday, Oracle HCM, Benefitfocus, LifeSuite, Alight, or carrier portals).
  • Data reconciliation and billing/premium reconciliation skills, including use of Excel (pivot tables, VLOOKUP, advanced formulas).
  • Reporting and analytics: ability to prepare utilization reports, enrollment summaries and forecast models.
  • Regulatory and compliance knowledge relevant to group benefits (e.g., ERISA, HIPAA, privacy legislation, pension and benefits regulations).
  • Basic SQL or data query experience to extract and validate membership and claims data (or demonstrated experience working with business intelligence tools).
  • Project coordination and UAT testing experience for implementations and system upgrades.
  • Document and records management, including secure handling of PHI and PII.
  • Familiarity with underwriting submissions, experience exhibits and renewal data packages.
  • Workflow automation and process improvement experience (Lean, Kaizen, or RPA exposure is a plus).
  • CRM or ticketing system experience (e.g., Salesforce, Zendesk) for tracking inquiries and SLA performance.
  • Strong Microsoft Office suite skills, especially Excel and Outlook.

Soft Skills

  • Exceptional written and verbal communication tailored to HR, brokers, members and technical teams.
  • Meticulous attention to detail and strong quality control mindset.
  • Customer-focused with a service-oriented attitude and ability to manage difficult conversations professionally.
  • Time management and prioritization skills to handle high volumes and competing deadlines.
  • Analytical problem solving: diagnose root causes and propose practical operational fixes.
  • Collaborative team player who builds productive relationships across internal and external stakeholders.
  • Adaptability to changing plan designs, regulatory updates and system changes.
  • Discretion and integrity when handling confidential employee and claims information.
  • Initiative and continuous improvement mindset — proactive in identifying process efficiencies.
  • Resilience under pressure and ability to maintain accuracy in a fast-paced environment.

Education & Experience

Educational Background

Minimum Education:

  • Bachelor's degree in Business Administration, Finance, Human Resources, Insurance, Risk Management or a related field; or equivalent combination of education and relevant work experience.

Preferred Education:

  • Professional designations such as Chartered Insurance Professional (CIP), Certified Employee Benefit Specialist (CEBS), LOMA or equivalent industry certifications.
  • Continuing education in benefits administration, compliance or HR systems.

Relevant Fields of Study:

  • Insurance
  • Business Administration
  • Human Resources Management
  • Finance
  • Actuarial Science
  • Risk Management

Experience Requirements

Typical Experience Range: 2–5 years of direct experience in group benefits administration, insurance operations or claims support.

Preferred: 5+ years experience administering group protection products (group life, disability, absence management), experience with client servicing for employer groups or broker relationships, demonstrated experience with benefits administration systems, billing reconciliation and regulatory compliance.

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