Benefits Coordinator

Location: Los Angeles, CA (Onsite)

Position Summary
The Benefits Coordinator serves as the Tier 2 specialist for the Retiree Medical Trust (RMT) program, providing advanced participant support and workflow oversight for all retiree medical benefit packets and reimbursements. This position bridges the functions of Member Services and Benefit operations to manage complex benefit scenarios, escalations, and compliance requirements related to Retiree Medical Trusts, beginning with the IAFF Medical Expense Reimbursement Plan (MERP) and expanding to additional RMT clients as assigned.

The Coordinator ensures accurate processing and timely resolution of benefit packets, maintains thorough documentation of procedures, and supports training and quality assurance for Tier 1 staff handling retiree inquiries.

Essential Duties and Responsibilities:

Benefit Packet Oversight:

• Oversee the end-to-end workflow for all RMT benefit packets, including initial review, tracking, follow-up, and completion.
• Verify completeness and accuracy of 16-page IAFF MERP packets, ensuring participant elections, required documents, and authorizations are received.
• Communicate with retirees, survivors, and employers to clarify plan options and eligibility.
• Coordinate with internal departments (Claims, Member Services, and Accounting) to ensure consistent handling of forms and contributions.

Tier 2 Participant Support:

• Act as the primary contact for escalated participant inquiries and complex benefit scenarios involving pooled, individual, and accumulated accounts.
• Interpret plan provisions (eligibility, benefit level, surviving spouse/child rules, COBRA, accumulated benefits, retiree contributions) using plan documents and amendments.
• Support the Annual Premium Verification process and review of participant proof of payment for accuracy and compliance.
• Maintain and update standard communication templates, FAQs, and participant correspondence.

Process Development & Quality:

• Document standard operating procedures for processing benefit packets and responding to Tier 1 inquiries.
• Train Member Services representatives on packet handling, benefit options, and claim submission requirements.
• Identify workflow gaps, recommend process improvements, and support implementation.
• Audit packet completion and claim accuracy to ensure compliance with plan rules and ERISA standards.

Cross-Functional Coordination:

• Partner with Claims Processors and Accounting on claim adjudication and payment timing.
• Collaborate with Employer Services to reconcile contribution discrepancies.
• Participate in system testing and feedback related to the Member Portal and Employer Portal enhancements for RMT clients.
• Provide data and reporting support for Board of Trustees meetings or audit requests.

Qualifications:
Education & Experience

• Bachelor’s degree in Business, Finance, or a related field preferred.
• Minimum 3 years of experience in employee benefits administration, retirement plan processing, or health and welfare trust administration.
• Experience in a third-party administration (TPA) or ERISA-governed environment preferred.
• Familiarity with retiree health plans, VEBA/RMT/MERP plan structures, and tax-exempt reimbursement benefits strongly desired.

Knowledge, Skills, and Abilities:

• Comprehensive understanding of benefit plan documentation, eligibility rules, and contribution tracking.
• Ability to interpret complex plan amendments and apply them to participant scenarios.
• Strong organizational skills and attention to detail in handling multiple active packet workflows.
• Excellent written and verbal communication skills, including experience communicating with retirees and union participants.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook) and familiarity with benefit administration or CRM systems.
• Demonstrated ability to train others and develop process documentation.
• Ability to maintain confidentiality and handle sensitive health and financial information in compliance with HIPAA.

Work Environment:
This position is based in the Los Angeles office and operates in a professional office environment. Standard work hours apply. Occasional extended hours may be required during implementation periods or processing deadlines.

Work Location: In person