Benefits, Eligibility,

Benefits Eligibility Prior Auths Specialist

Posted today

Job Description

The Benefits Specialist is responsible for administering and managing employee benefits programs, including government-mandated benefits, HMO processing, and company-initiated benefits. The role ensures accurate enrollment, updates, and deactivation of benefits, while maintaining compliance with labor laws and company policies. The Benefits Specialist also serves as the primary contact for employee benefit inquiries, ensuring a smooth and positive experience for all employees.

Role and Responsibilities:

• Manage SSS, PhilHealth, and Pag-IBIG contributions, loan applications, and reporting.
• Ensure timely and accurate remittances in compliance with government requirements.
• Coordinate with government agencies for compliance updates, inquiries, and issue resolution.
• Administer HMO enrollments for employees and qualified dependents.
• Process HMO updates such as upgrades, removals, and coverage adjustments.
• Facilitate HMO deactivation and proper coordination with providers during employee separation or changes in eligibility.
• Monitor and escalate concerns related to HMO claims, reimbursements, and utilization.
• Assist in the administration of company-provided benefits such as allowances, incentives, recognition programs, wellness initiatives, and other perks.
• Coordinate with vendors and service providers to ensure smooth rollout of benefit programs.
• Provide support to HR in recommending benefit enhancements based on employee needs and industry best practices.
• Act as the first point of contact for employee inquiries regarding benefits, leave, and entitlements.
• Provide guidance on eligibility, documentation, and claims procedures.
• Maintain updated and accurate records of all employee benefits.
• Prepare and submit reports on benefit utilization, costs, and compliance to Immediate Head.
• Ensure compliance with the Philippine Labor Code and data privacy regulations in benefits administration.
• Coordinate with payroll to ensure proper deductions and adjustments related to benefits.
• Work with HR, Finance, and vendors to improve benefit-related processes.
• Suggest and implement process enhancements to increase efficiency and employee satisfaction.

Qualifications:

• Bachelor's degree in Human Resource Management, Business Administration, Psychology, or any related field.
• At least 3–5 years of experience in employee benefits administration, including government-mandated benefits, HMO, or company-initiated programs.

Knowledge & Skills:

• Strong knowledge of SSS, PhilHealth, Pag-IBIG, and labor law provisions on employee benefits.
• Hands-on experience in HMO processing, updates, and deactivation.
• Familiarity with company-initiated benefit programs and vendor coordination.
• Proficiency in MS Office; HRIS knowledge is an advantage.
• Strong organizational skills, attention to detail, and data accuracy.
• Excellent communication and interpersonal skills.

Other Requirements:

• High level of integrity and confidentiality in handling employee data.
• Customer service orientation and problem-solving mindset.
• Ability to work independently and collaborate effectively with HR and cross-functional teams.

Note: This job description is not intended to be all-inclusive. Employee may perform other related duties as negotiated to meet the ongoing needs of the organization.

What We Offer

• A chance to shape recruitment strategies from the ground up.
• Dynamic startup culture with room to grow.
• Competitive compensation and performance incentives.

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