Benefits Billing/Operations Analyst

Position Summary

The Benefits Billing & Operations Analyst is responsible for the strategic administration and oversight of benefit billing operations for multiple Taft-Hartley trust funds and employee benefit plans. This position serves as the operational owner of benefit billing data integrity by independently analyzing complex billing, eligibility, and financial reconciliation issues; leading routine and ad hoc audits; identifying operational and financial risks; and implementing corrective actions. The role is responsible for establishing and maintaining effective internal controls, ensuring the accuracy of participant eligibility, employer contributions, premium billing, and trust fund financial transactions while collaborating with internal leadership, trustees, vendors, auditors, and legal counsel to support the effective administration of employee benefit programs.

"Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role."

Key Duties and Responsibilities

• Develop standardized audit procedures and reconciliation methodologies.
• Perform comprehensive audits of participant eligibility, employer contribution records, premium invoices, carrier billings, payroll deductions, trust fund transactions, and vendor invoices to ensure financial accuracy, regulatory compliance, proper plan administration, and timely resolution of discrepancies.
• Analyze large volumes of benefits, billing, enrollment, eligibility, and financial data to identify trends, anomalies, operational risks, and opportunities for automation and continuous pro
• Conduct. complex financial reconciliations between employer contributions, trust accounting records, payroll deductions, carrier invoices, participant eligibility, and billing systems. Investigate discrepancies, determine root cause, and implement corrective actions to ensure financial integrity.
• Manage benefits-related audits, including trust benefit audits, monthly employee deduction audits, 401(k) audits,
• Review and approve complex billing adjustments, retroactive premium corrections, eligibility determinations, and reconciliation activities.
• Administer and manage group health, dental, vision, life, disability, and 401(k), including complex enrollments, life events, and compliance reporting.
• Process benefits enrollments, changes, and terminations.
• Respond to employee inquiries regarding benefits eligibility, plan provisions, claims and coverage issues.  Resolve escalated issues as needed
• Prepare and maintain documentation related to benefit plans and leave administration in compliance with applicable federal and state regulations.
• Support benefits renewal processes with updates to benefits summaries, Workday benefits portal setup.
• Analyze employee utilization trends, claims experience, and participant feedback to recommend enhancements to benefit programs.
• .
• Analyze and interpret plan documents, collective bargaining agreements, administrative policies, and eligibility provisions to ensure accurate trust billing administration.

• Exercise independent judgment in resolving complex participant, employer, and vendor billing issues.
• Develop, implement, and maintain operational workflows, process controls, and billing procedures that improve efficiency, strengthen internal controls, and ensure compliance with established service standards and due dates. Serve as a subject matter expert (SME) on benefit billing processes, eligibility rules, and trust fund administration.
• Performs other duties as assigned.

Minimum Qualifications

• Bachelor’s degree in business administration, Human Resources, Accounting, Finance, or a related field; equivalent combination of education and experience may be considered.
• 3+ years of progressively responsible experience in employee benefits administration, trust fund administration, accounting, finance, payroll, or related field.
• Demonstrated experience performing financial reconciliations, operational audits, or data integrity reviews.
• Strong understanding of federal and state regulations governing benefits, including ERISA, HIPAA, COBRA, ACA, and FMLA.
• Experience administering complex employee benefit plans, multiemployer plans, or Taft-Hartley trust funds preferred.
• Demonstrated ability to make recommendations that influence operational, financial, and administrative decisions.
• Advanced Microsoft Excel skills including Pivot Tables, VLOOKUP, formulas, and data validation.
• Excellent communication, problem-solving and organizational and analytical skills.
• Highly organized, self-motivated, and detail orientated.

Preferred Qualifications

• Professional certification, such as Certified Employee Benefits Specialist (CEBS) or PHR/SPHR.
• Experience with internal audit methodologies and financial reconciliation processes.
• Experience developing operational procedures, internal controls, and compliance programs.
• Experience supporting SOC audits, ERISA audits, DOL audits, IRS audits, or external financial audits.
• Demonstrated ability to make recommendations that influence operational, financial, and administrative decisions.

*Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee of this job.  Duties, responsibilities and activities may change at any time with or without notice.

Working Conditions/Physical Effort

• Prolonged periods of sitting at a desk and working on a computer.
• Normal degree of physical effort in a typical office environment with comfortable, constant temperatures and absence of objectionable elements.
• Lift up to 15 pounds

Disability Accommodation

Consistent with the Americans with Disabilities Act (ADA) and other applicable federal and state law, it is the policy of Zenith American Solutions to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If reasonable accommodation is needed, please contact the Recruiting Department at recruiting@zenith-american.com, and we would be happy to assist you.

Zenith American Solutions

Real People. Real Solutions. National Reach. Local Expertise.

We are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day.

Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. The original entity of Zenith American has been in business since 1944. Our company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. By combining resources, best practices and scale, the new organization is even stronger and better than before.

We believe the best way to realize our better systems for better service philosophy is to hire the best employees. We're always looking for talented individuals who share our dedication to high-quality work, exceptional service and mutual respect. If you're interested in working in an environment where people - employees and clients - really matter, consider bringing your talents to Zenith American!

We realize the importance a comprehensive benefits program to our employees and their families. As part of our total compensation package, we offer an array of benefits including health, vision, and dental coverage, a retirement savings 401(k) plan with company match, paid time off (PTO), great opportunities for growth, and much, much more!