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By Rohais Leger. Resume. Published at Sunday, August 18th, 2019 - 03:45:29 AM.

Managed all aspects of group benefit programs to include medical, dental, vision, life, 401k, Cobra, FMLA, LOA and payroll processing covering four states and 800+ employees. Handled Annual and Special Enrollment periods to include additions, terminations and changes. In charge of invoice reconciliation, vendor and broker relationships. Worked closely with broker to ensure compliance with Health Care Reform mandates. Worked with Employment Risk Services regarding work related injuries and processes. In charge of recruitment and retention for all franchises. Handled interview process, drug screening, new hire orientation, background and credit checks.

Responded to; inquiries from employees, retirees, carriers, physicians, and attorneys for benefits coverage, eligibility, claim procedures, as well as fund regulations and specifics. Updated and maintained, annual enrollment and demographic information for members and their dependents. Consulted with, retirees in person or by phone to review the process of continuing benefits after retirement. Assisted employees with filing health, dental, and prescription claims for reimbursement. Keyed and processed hard copy medical, dental, and prescription claims based on set contract rates and pricing. Completed enrollment process through receiving and verifying enrollment forms, received dependent documentation; processed QMSO cases.

Worked with the Accounting Department to successfully develop a more cost effective and time saving Medical and Dental Premium Reconciliation process; this allowed the process to move independently to the Human Resources Department. Independently and accurately identified and reconciled billing discrepancies by utilizing eligibility reports run in People Soft in order to remit correct payment. Corrected eligibility errors through vendor contact and eligibility file maintenance to sustain employee coverage. Paid monthly premiums and administrative fees to all medical, dental and FSA plans in a timely manner. Acted as key contact regarding the FSA program; answered employee questions and maintained and transmitted eligibility and contribution files. Quickly resolved escalated employee benefits issues that were received in the company’s Benefits call-center. Conducted New Hire Benefits Orientations to ensure employees a thorough understanding of their benefits choices. Participated in special projects such as Open Enrollment, Benefits Fairs, and Wellness Seminars.

Administered benefits for seven thousand staff and billable employees of company. Extracted info from specialized reports via Excel and ADP systems to prep carrier payments. Assisted participants with enrollment, benefit, and payroll deduction related questions as needed via phone and/or email. Retrieved from and/or sent info to multiple carriers regarding enrollment for benefits. Developed, maintained, and updated procedures for reports processing and other activity.

Oversaw the outsourced relationship for managed disability and Family Medical Leave operations coordinating workflow with vendors, and collaborating with HR Business Partners nationwide. Managed escalated disability issues and appeals for union and non-union employees ensuring timely and compliant resolutions. Conducted analysis of data in health and welfare vendor’s system to ensure accuracy, conducts data comparisons between internal and external systems. Investigated, researched and responded to inquiries from participants on pension benefits, eligibility for pension survivor benefits and retiree medical and life insurance. Coordinated internal and external audit activity for pension plan. Partnered with third party vendor to validate and confirm final data for pension calculations. Established and executed the process to identify, notify and transition disabled employees to Medicare.

Payroll Specialist and Benefits Administrator, Promoted from Payroll and Benefits Specialist to current position after 2 years. Managed multi-state semi-monthly payrolls for four companies using Paycheck. Coordinated with CFO to implement the transition from one company to a combination of four non-profit and for-profit entities, each with its own payroll and benefits plan. Administered all benefits (Health, Dental, Life, 401(k), 125 Plan, COBRA, FSA, Disability and Unemployment) to ensure consistency and audit-readiness. Liaison between employees and insurance companies to resolve issues. Collaborated with Executive Management to negotiate a new benefits package which resulted in a 5% savings and a 90% employee satisfaction rate.


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