Business System Analyst

Position: Business Systems Analyst

Practice: Health and Welfare Ops

Job Title: Business Systems Analyst

Reporting To: Manager

Experience: 5+ Years

Role Overview:

The Business Systems Analyst (BSA) is accountable for completing systems development, quality assurance, and day-to-day operational tasks in support of ongoing health and welfare benefits administration, both internally and externally to clients within their portfolio and/or aligned pod.

The BSA ensures that all work delivered to the client is configured accurately per system requirements, including assigned Annual Enrolment configuration responsibilities and dual-year tasks. This role requires expertise in employer benefits plan administration, including eligibility management, health insurance configuration, enrolment processing, and coordination across HR benefit administration systems and insurance carriers.

Key Responsibilities and Duties:

• Employer Benefits Plan & Health/Welfare Administration : Manage medical insurance (PPO, HMO, HDHP), dental, vision, HSA/FSA, life, and disability plans. Ensure compliance with ERISA, ACA, COBRA, HIPAA, Section 125, MHPAEA, ADA, FMLA, and state insurance regulations.
• Eligibility, Enrollment & Benefits Changes : Process employee eligibility determination, open enrollment, qualifying life events (QLEs), and employment status changes (hire, termination, LOA, rehire). Submit timely and accurate carrier reporting.
• System Management (Workday, ADP, Paychex, UKG) : Manage employee data, eligibility feeds, and benefit deductions across HRIS and payroll platforms. Reconcile information across systems with strong controls and accuracy.
• Carrier Coordination & Premium Management : Coordinate with health insurance carriers on eligibility files (834/flat files), EOI decisions, coverage terminations, reinstatements, and premium billing reconciliation.
• COBRA Administration : Process qualifying events, manage election notices within DOL timelines, coordinate billing with vendors (WEX, Inspira, Discovery Benefits), and maintain audit documentation.
• Compliance Reporting & Data Security : Prepare ACA compliance reporting (Forms 1094/1095), maintain HIPAA-compliant data handling (secure transfers, access controls), and support internal/external audits.
• Employee Support & Issue Resolution : Answer eligibility and enrollment questions, generate ERISA notices, troubleshoot system discrepancies, and resolve benefits administration issues.
• Financial Controls & Reconciliation: Reconcile employee/employer contributions, carrier remittances, and payroll deductions. Process refunds and corrections with audit-ready documentation.

Required Qualifications

• Domain experience in health insurance administration, employer benefits plan management, and/or HR benefit administration
• Strong knowledge of health and welfare benefits, including eligibility, enrollment, and benefits configuration
• Experience with MS Excel
• Working knowledge of case or ticket management systems, such as CRM or Atlassian JIRA
• Understanding of testing methodology and test planning
• Demonstrated analytic and design capabilities
• Experience with SQL and working knowledge of relational database systems