Senior Benefits Advisor

Major duties include but are not limited to the following:

• Maintain accurate case and program data in agency systems; produce clear plain-language communications; leverage technology tools; and support team operations by assisting/mentoring junior advisors and helping the supervisor monitor unit performance.
• Provide technical information and guidance to participants beneficiaries plan administrators and other stakeholders on ERISA COBRA ACA HIPAA MHPAEA and related Department guidance; respond to inquiries and educate individuals on their rights and responsibilities.
• Resolve benefits disputes through informal dispute resolution securing benefit recoveries when appropriate; identify matters suggesting fiduciary violations or complex issues and prepare referrals to investigative staff.
• Conduct research and analysis by obtaining and reviewing plan documents employment and payroll records collective bargaining agreements financial/disclosure statements and claim files to assess eligibility interpret plan provisions and laws and prepare accurate written responses and recommendations.
• Plan and deliver outreach and education (in-person and remote) to the public and regulated community-including underserved populations-by organizing events coordinating logistics partnering with agencies/organizations and disseminating/updating outreach materials.

• Must be at least 16 years old.
• Must be a U.S. Citizen.
• Candidate required to obtain the necessary security/investigation level.
• Requires a probationary period if the requirement has not been met.
• In some regions a drivers license may be required.

Specialized Experience is the experience that equipped the applicant with the particular knowledge skills and abilities (KSAs) to perform the duties of the position successfully and that is typically in or related to the position to be filled. To be creditable specialized experience must have been equivalent to at least the next lower grade level.

Applicants must demonstrate 52 weeks of specialized experience equivalent to at least the next lower grade level GS-12 in the Federal Service. You must meet 3 out of the 4 examples of specialized experience listed below. Qualifying specialized experience is defined as:

1. Providing technical guidance of Title I of Employee Retirement Income Security Act of 1974 (ERISA) and related statutes (COBRA ACA HIPAA MHPAEA) by interpreting retirement plan provisions advising plan administrators participants and beneficiaries and resolving multifaceted regulatory and compliance issues;
2. Conducting comprehensive fact-finding by obtaining and analyzing retirement plan documents collective bargaining agreements employment and earning records financial and disclosure reports and insurance and medical claims to evaluate eligibility and entitlement develop evidence-based findings and prepare well-supported written analyses and recommendations;
3. Leading dispute resolution and negotiations with plan sponsors fiduciaries and service providers to secure voluntary compliance and recover employee benefits and identifying potential civil or criminal violations and preparing investigative referrals in accordance with agency procedures; and
4. Planning and executing strategic outreach and education (in person and remote) initiatives for diverse and underserved audiences by coordinating event logistics cultivating partnerships with Federal State and local and non-profit organizations delivering technical presentations and developing and disseminating educational materials to promote program awareness and compliance.