Benefits • Award-winning culture • Inclusion and diversity as a priority • Performance Based Incentive Plans • Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability • Generous PTO (including paid time to volunteer!) • Up to 9.5% 401(k) employer contribution • Mental health support • Career advancement opportunities • Student loan repayment options • Tuition reimbursement • Flexible work environments • All the benefits listed above are subject to the terms of their individual Plans. And that’s just the beginning… This position is an advanced level technical position responsible for the thorough, fair, objective, and timely adjudication of the most complex short‑term disability claims in conjunction with providing technical expertise regarding FMLA and state leave regulations. Principal Duties and Responsibilities • Timely and accurate adjudication of complex STD claims • Processing of leaves associated with an employee’s own health condition • Apply technical contractual knowledge (policies and provisions) to ensure appropriate eligibility requirements and liability decisions • Determine complex eligibility and availability of leave for integrated claims/leaves • Responsible for timely and accurate claims review, initiation and completion of appropriate claim validation activities, and effective communication of rationale for claims action • Determine and generate appropriate communications to comply with FMLA and State regulations and customer procedures • Facilitate round tables when consulted or manager is unavailable • Provides technical coaching and mentor support to less experienced Benefit Center professionals • Provides Manager/Director with performance and development feedback for assigned mentees • Is viewed as a role model, technical expert and leader within the team and Benefits Center • Provides coverage of daily tasks including customer inquiries and attending customer calls as needed and in times of management absence • Verify on‑going liability and return to work opportunities as appropriate • Provide excellent customer service by paying appropriate claims promptly and quickly and independently responding to all inquiries within Benefits service guidelines • Develop relationships with Employer contacts, including HR administrators • Coordinate file strategies utilizing specialized resources including nurses, physicians, vocational rehabilitation and assessing medical documentation • Ensure timely referrals/notifications to other areas (i.e., LTD, medical assessments, etc.)
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