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Claims Specialist (Must Reside in CT)

The Company:  true
The Location: 

CT, US Remote, US

The Division: 
Job Id:  482

                                                             Must Reside in CT

Job Summary

Under general supervision of the team manager, this position is responsible for administering various clients’ Family Medical Leave Act (FMLA) policy and performing various clerical duties to support the administration and operational functions of the unit.


Principal Duties & Responsibilities

Assists associates with leave of absence requests and guides them through the process


Processes all leave of absence paperwork according to established procedures and laws


Provides timely and accurate responses to associates and all levels of management concerning day-to-day issues and activities


Administers the FMLA policy; reviews FMLA documentation for accuracy and completeness


Makes recommendations to approve or deny requests for FMLA based on federal regulations


Coordinates correspondence, forms, and other documents via the claim system


Generates reports as required; maintains files, inputs and analyzes data


Assists management with leave of absence situations and provides guidance within the policy and established legal guidelines


Keeps complete records of all LOA requests and maintains tracking and analysis of data


Participates in developing goals, objectives, and systems


Maintains compliance with standards and federal/state regulations


Serves as an internal reference to the team for certification requirements and processing


Contacts Providers for clarification


Supports management with special projects as necessary


Performs other duties as assigned


Education & Experience

Bachelor's Degree In a related field, 1 - 2 years of related experience, Or an equivalent combination of education and experience


Job Knowledge & Skills

Current knowledge of the integrated disability and absence management industry


Excellent customer service skills and ability to manage difficult and stressful situations


Strong communication skills – written, verbal, persuasion, motivation, facilitation of strong working relationships


Ability to manage business expectations and resolve concerns, by communicating status and issues


Ability to effectively prioritize and escalate customer issues


Ability to interpret and analyze multiple facts


Knowledge of state and federal FMLA regulations


Knowledge of medical disability management preferred


Strong organizational skills


Excellent interpersonal skills


Ability to work in a team environment


Ability to meet or exceed Performance Competencies


Organizational Competencies

Acting with Integrity, Communicating Effectively, Pursuing Self-Development, Serving Customers, Supporting Change, Supporting Organizational Goals, Working with Diverse Populations