Benefits Specialist
Wright State University
Dayton, OH (In Person)
Full-Time
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Job Description
The Benefits Specialist - Student Health reports to the Director of Benefits and assists in the implementation and administration of the university's student benefits programs. This position serves as the primary liaison between students and health insurance carriers. This Benefits Specialist - Student Health oversees the administration of student-centric insurance programs, processes complex claims, and ensures data integrity through rigorous reconciliation. The role provides policy interpretation and technical support through the University's Benefits Center of Excellence. Minimum Qualifications Bachelor's degree and two years of experience in student services, campus health, benefits administration, insurance administration, customer service, human resources, or a related field; or Associate's degree and four years of related experience; or high school diploma or equivalent and six years of related experience. Demonstrated ability to maintain confidentiality under applicable FERPA, HIPAA, university policy, and data privacy expectations. Strong verbal and written communication skills. Ability to explain complex insurance information clearly to students, dependents, and campus partners. Strong analytical, organizational, and problem-solving skills with significant attention to detail. Demonstrated ability to interpret insurance plan requirements or university policies, resolve administrative issues, and escalate complex matters appropriately. Ability to work effectively with students, dependents, families, vendors, medical providers, campus partners, and colleagues at all levels of the organization. Demonstrated ability to work independently and collaboratively, manage multiple priorities, and meet deadlines. Proficiency with Microsoft Office products, including Excel skills such as pivot tables, lookups, data reconciliation, and analysis. Ability to learn and use student, benefits, billing, vendor portal, document management, and reporting systems. Integrity and judgement necessary to maintain strict confidentiality at all times. Good judgement, diplomacy and objectivity to effectively and appropriately make decisions. Preferred Qualifications Experience in higher education. Experience with student health insurance, student services, campus health, benefits administration, insurance carriers, or third-party administrators. Familiarity with student information systems, insurance carrier portals, billing systems, HRIS systems, or benefits administration platforms. Experience creating student-facing communications, presentations, forms, FAQs, or web content. Knowledge of health insurance terminology, eligibility processes, waiver administration, claims assistance, or appeals coordination. Essential Functions and percent of time: 40% Essential function : Student Benefit Administration & Claims Coordination Coordinate the end-to-end insurance (medical, dental, vision, disability, and life insurance) enrollment process for the student body; maintain accurate records and perform high-level reconciliation of insurance premiums. Support the evaluation and processing of claims; serve as the primary liaison between students, providers, and carriers to resolve disputes and verify coverage eligibility. Audit accounts to ensure billing requirements are met; investigate recurring inquiries and provide recommendations for the resolution of contested or denied claims. Interpret policy to address interoffice and student concerns; determine specific actions for recurring administrative bottlenecks. 20% Essential function : Strategic Vendor Relations & RFP Support Provide technical data and support for the development of Requests for Proposals (RFPs). Assist in the annual review of Student Health Insurance Program (medical, dental, vision, disability and life insurance). Assist with the facilitation of quarterly meetings with benefit vendors; analyze contract performance and provide input on potential solutions for service gaps. 20% Essential function : Benefits & Wellness Support the coordination of the employee Tuition Remission benefit with focus on employee awareness. Support the coordination the Employee Assistance Program and facilitate vendor relationship with focus on employee awareness. Support in the coordination of large-scale employee benefits offerings (e.g. the annual benefits fair, annual flu shots, biometric screenings, open enrollment, pathway to retirement, etc.). Serve as a member of the Health and Wellness Task Force and Employee Health and Wellness Committee. Essential Functions and percent of time (cont'd): 15% Essential function : Specialized Communication & Outreach Facilitate and lead benefit presentations for student orientations, attend student fairs and related events. Provide direct assistance to students regarding benefit inquiries and eligibility issues. Draft clear, concise communications (web, videos, and print) to improve student understanding of the Student Health Insurance Program. 5% Essential function : Reporting and Appeal Compile and summarize data to prepare mandatory compliance reports and internal files. Non-Essential Functions and percent of time: none