Rutgers, The State University of New Jersey is seeking a Benefits Functional Specialist – Health Benefits for the Benefits department of University Human Resources. The Benefits Functional Specialist – Health Benefits is a key member of the University Human Resources (UHR) Benefits Enrollment team and is responsible for delivering accurate, timely, and high‑quality service to the Rutgers community. This position provides specialized expertise in the administration of State Health Benefit Plans (SHBP), supporting approximately 23,000 active employee enrollments. The Specialist manages health benefits eligibility, enrollment, leave‑related billing, and employee guidance, ensuring full compliance with State and University policies. The role also functions as a primary liaison with the New Jersey Division of Pensions and Benefits (NJDPB), Benefit Solver, payroll, and OneSource to resolve complex benefit matters and support employees throughout the benefits lifecycle.
Among the key duties of this position are the following:
Health Benefit Administration
- Interprets and explains SHBP provisions, eligibility rules, coverage options, and cost calculations as defined by NJDPB.
- Assists employees with the Benefit Solver enrollment platform and supports navigation of state‑mandated requirements.
- Reviews and certifies dependent enrollments in Benefit Solver, including documentation verification and eligibility determinations.
- Processes health benefit enrollment transactions and dependent record setup in PeopleSoft in accordance with eligibility rules and payroll deadlines.
- Calculates, enters, and validates health plan rate adjustments, corrections, and refunds in PeopleSoft.
- Ensures adherence to all applicable procedural, policy, and legislative requirements governing health benefit programs.
Leave of Absence Billing & Payment Management
- Serves as the primary contact for employees regarding continuation of health coverage while on unpaid leave of absence.
- Generates, issues, and tracks medical plan leave‑of‑absence billing in accordance with university schedules and policies.
- Follows up on outstanding payments and processes remittances, ensuring timely deposit and accurate recordkeeping.
- Prepares and maintains monthly reconciliation of employee leave‑related remittances for financial accounting .
Employee Support & Case Resolution
- Researches and resolves complex health benefit inquiries escalated from OneSource, providing accurate and thorough responses.
- Documents all case activity in the OneSource case management system following established protocols.
- Coordinates with NJDPB, Benefit Solver, and payroll teams to resolve eligibility discrepancies, enrollment issues, and billing concerns.
Compliance, Audits, Knowledge Management & Continuous Improvement
- Participates in routine audits, data validation initiatives, and system clean‑up efforts to maintain data integrity.
- Develops, updates, and maintains internal processes, workflows, and procedural documentation.
- Creates and updates Knowledge Articles for OneSource staff and employees on SHBP and other benefits programs.
- Identifies opportunities for process improvements, efficiencies, and technology enhancements across health benefit operations.
- Engages in training and development initiatives to support staff capabilities and promote consistent service delivery.
Minimum Education and Experience:
Bachelor's degree or an equivalent combination of education and relevant experience.
