The Enhanced Services Specialist is responsible for executing dependent verification audits, assisting with billing reconciliation tasks, and providing Tier 1 support for client inquiries. This role ensures accurate data processing, maintains compliance with regulatory guidelines, and works collaboratively with internal teams to resolve service-related issues. The Specialist plays a key role in supporting day-to-day operational tasks while gaining hands-on experience in benefits administration and compliance functions. This position interacts directly with employees, HR teams, and broker partners to ensure seamless service delivery.
RESPONSIBILITIES
Dependent Verification & Compliance
Processes dependent eligibility verification requests, ensuring compliance with ERISA and client-specific policies.
Reviews supporting documentation, such as birth certificates, marriage certificates, and proof of joint ownership, to confirm eligibility.
Supports audit processes by ensuring accurate record-keeping for dependent audits and escalating any discrepancies to the Sr. Specialist or Manager.
Billing Reconciliation & Data Processing
Assists with carrier billing reconciliation efforts, ensuring alignment between premium payments and active participant data.
Identifies and resolves basic billing discrepancies, while escalating complex cases to Sr. Specialists for further resolution.
Works with Tabulera and internal systems to validate data accuracy and compliance.
Service Center & Client Support
Handles Tier 1 inquiries from employees, HR teams, and broker partners, providing guidance on dependent verification, billing issues, and benefits access.
Troubleshoots basic system navigation questions, resets passwords, and assists with login issues.
Escalates more complex issues to the Sr. Specialist or Manager as needed.
Data Accuracy & Compliance Support
Maintains accurate and updated records across internal systems and documentation sources.
Supports compliance efforts by assisting with documentation tracking, quality assurance checks, and identifying potential data discrepancies.
Collaborates with internal teams to ensure data integrity and adherence to service standards.
Process Support & Continuous Learning
Participates in training sessions to enhance expertise in dependent verification, billing reconciliation, and compliance regulations.
Assists in refining standard operating procedures (SOPs) and contributes feedback for workflow improvements.
Collaborates with team members to enhance service efficiency and accuracy.
QUALIFICATIONS
Required Qualifications
Bachelor's degree in Business, Human Resources, or a related field preferred.
1-2 years of experience in benefits administration, billing reconciliation, or customer service.
Familiarity with benefits administration technology, such as DependentsAudit, Tabulera, Employee Navigator, bswift or similar systems.
Intermediate Excel skills (data entry, filtering, basic formulas) and knowledge of CRM or ticketing systems (e.g., Zoho or similar).
Strong attention to detail and ability to manage multiple priorities.
Excellent verbal and written communication skills with a client-focused approach.
Ability to work in a fast-paced environment and collaborate effectively with team members.
Core Competencies
Technical Proficiency & Problem-Solving - Ability to navigate benefits administration platforms and resolve basic participant inquiries.
Client Service & Relationship Management - Provides timely and professional support to employees and HR teams.
Compliance & Data Accuracy - Maintains accurate records and follows regulatory guidelines.
Collaboration & Communication - Works effectively across departments to ensure seamless service delivery.
Adaptability & Continuous Learning - Willingness to develop expertise in benefits technology and compliance processes.