Reporting to the Assistant Director, Specialized Markets, the Group Benefits Specialist will be supporting the administration of complex group benefit plans for plan sponsors and members, ensuring the accuracy, integrity, and timely processing of member and plan information.

The successful candidate enjoys working with data, investigating discrepancies, solving problems, and ensuring a high level of accuracy in plan administration. This role combines benefits administration, eligibility management, data analysis, billing reconciliation, auditing, and member support within a collaborative and fast-paced environment.

Key Responsibilities

Benefits Administration & Eligibility Management

- Administer member enrolments, terminations, beneficiary changes, dependent updates, and other eligibility-related transactions
- Review and validate plan member information to ensure accurate and up-to-date records
- Support annual benefit enrolment activities and benefit selection changes
- Assist members with over-age dependent verification, required documentation, and eligibility requirements
- Prepare, validate, and transmit member eligibility and benefits files to insurance carriers
- Maintain member records in accordance with privacy and confidentiality requirements

Data Analysis, Auditing & Reconciliation

- Analyze member, eligibility, and billing data to identify discrepancies, and required actions
- Compare, validate, and reconcile data files received from multiple sources
- Conduct regular data audits to ensure the integrity and accuracy of member and plan information




- Investigate and resolve eligibility, coverage, billing, and administrative discrepancies
- Process and reconcile member payments and billing information
- Gather and analyze data required for monthly billing activities and reporting
- Prepare reports and supporting documentation for review and decision-making

Member & Client Support

- Serve as a key point of contact for plan sponsors and plan members
- Respond to inquiries related to group benefits, eligibility, coverage, claims, plan options, flex plans, and premiums
- Assist members with questions related to disability benefits, Employment Insurance (EI), and Workplace Safety and Insurance Board (WSIB/WCB) claims
- Support members in navigating online member portals and insurance carrier platforms
- Investigate and resolve member and client concerns in a professional and timely manner
- Respond to telephone and email inquiries within established service standards

Operational Support

- Generate correspondence, member communications, mail merges, and other required documentation
- Assist with the preparation and administration of T4A tax slips, as required




- Participate in team meetings and contribute to process improvements and operational efficiencies
- Support special projects and perform other related duties as assigned

Required The ideal candidate will have the following qualifications:

- Minimum 2-3 years of experience in perks administration, insurance, pension administration, payroll, HR administration, finance, data administration, or a related field
- Strong analytical and problem-solving skills
- Demonstrated ability to review, reconcile, and validate data with a high degree of accuracy
- Excellent attention to detail and organizational skills
- Solid verbal and written communication skills
- Proficiency with Microsoft Excel and Microsoft Office applications
- Ability to manage competing priorities and meet deadlines

Preferred

- Experience administering group benefit plans
- Experience working within a TPA, ELHT, insurer, brokerage, pension, payroll, or employee benefits environment
- Knowledge of eligibility administration, billing reconciliation, claims processes, and group benefits operations
- Experience working with multiple data systems and large datasets

Key Qualities

- Naturally curious and enjoy investigating issues to determine root causes
- Comfortable working with data and identifying discrepancies
- Highly organized, detail-oriented, and accurate
- Able to balance analytical work with member and client support responsibilities
- Committed to delivering exceptional service while maintaining data integrity and compliance

📌 Group Benefits Specialist (Markham)
🏢 AGA Benefit Solutions
📍 Markham