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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