Senior Client Benefits Specialist

With its expanding activities, AGA Benefit Solutions offers new employment prospects for professionals with high career aspirations. If you are seeking flexibility, freedom and challenges, this position is made for you!
Our firm is committed to its employees and welcomes all new candidates in a respectful manner consistent with an excellent work environment. Discover why working at AGA Benefit Solutions is so rewarding by visiting our Career page .
Your mandate will consist in:  Your mandate will be to manage the administration, analysis, auditing, and day-to-day operations of complex group benefit plans. You will act as a subject matter expert on benefits, contracts, billing, eligibility, and administration, while working with clients, insurers, consultants, and internal teams to resolve issues and ensure accurate plan management. The role requires strong knowledge of group benefits, an analytical mindset, and an affinity for systems and databases.

Read on to discover the skills and qualifications needed to succeed at AGA!
Your main tasks will include:  Benefits Administration Oversight & Eligibility Management   Oversee the administration of member eligibility, enrolments, terminations, beneficiary updates, dependent changes, and other benefit transactions to ensure accuracy and compliance with plan provisions.
Review and validate member and plan data to maintain accurate records and support effective plan administration.
Coordinate and manage annual enrolment activities, benefit changes, and complex eligibility situations.
Manage over-age dependent reviews and ensure eligibility requirements and supporting documentation are met.
Prepare, validate, and transmit eligibility and benefits information to insurers and third-party providers.
Ensure member records are maintained in accordance with privacy, confidentiality, and regulatory requirements.
Contract Interpretation & Benefits Expertise   Interpret and apply group insurance contracts, policies, employee booklets, and administrative agreements.
Serve as a subject matter expert on group benefits administration, insurance provisions, and industry practices.
Apply specialized knowledge of:  E ligibility and enrolment requirements
Disability, EI, and WSIB/WCB-related benefit administration
Contract and policy provisions
Life insurance provision s and beneficiary designations
Non-evidence maximum rules

I dentify and resolve discrepancies between contractual requirements, insurer practices, and administration system configurations.
Provide guidance to clients, insurers, consultants, and internal stakeholders regarding complex benefit matters.
Analyze member, eligibility, billing, and insurer data to identify trends, discrepancies, risks, and required corrective actions.
Reconcile information across benefit administration systems, insurer records, and client data sources.
Conduct audits to ensure data integrity, contractual compliance, and accuracy of member and plan information.
Investigate and resolve eligibility, coverage, enrolment, premium, billing, and administrative discrepancies.
Prepare and review reports, analyses, and supporting documentation to support client service, decision-making, and operational performance.
Monitor administrative processes and identify opportunities to improve data quality and operational effectiveness.
Billing & Financial Administration   Audit insurer billing statements and premium calculations to ensure plan changes and rates are accurately reflected.
Review billing adjustments, reconciliations, member payments, and financial transactions related to benefit plans.
Identify, investigate, and resolve billing discrepancies with insurers, clients, and internal stakeholders.
Prepare monthly billing and financial reporting/remittance requirement for specified clients.
Assist with benefit-related tax reporting, including T4A production, as required.
Client Relationship Management & Member Support   Act as the primary day-to-day contact for assigned clients, providing expert guidance on benefits administration and plan operations.
Respond to complex inquiries regarding eligibility, coverage, claims, premiums, flexible benefit programs, disability benefits, and insurer processes.
Build and maintain collaborative relationships with clients, members, consultants, insurers, and internal stakeholders.
Investigate and resolve escalated member and client issues in a professional and timely manner.
Support members in navigating insurer and benefits administration platforms and…