FMLA Leave Claims Specialist

Job Summary

To support the evaluation of Paid Family & Medical Leave claims, the full-time FMLA Leave Claims Specialist will manage claims processing, make independent decisions based on thorough analysis, and maintain professional relationships with various stakeholders while working remotely.

Key responsibilities

• Evaluate claims and gather necessary information to formulate action plans and recommendations
• Develop and document files demonstrating appropriate decision-making based on claims facts and regulations
• Determine financial liability and manage claims processing to ensure timely and accurate payments

Required qualifications

• Understanding of complex insurance provisions and the ability to apply regulations to claims
• Experience analyzing vocational and medical information for claims decisions
• Proficiency in using multiple systems for task management and meeting deadlines
• Strong organizational skills and adaptability to change in a remote work environment
• Access to a high-speed internet connection and residence in the United States or Puerto Rico