You are:

The Leave Administation Specialist for non-occupational and workers' compensation leaves, responsible for the proactive management of claims. This includes investgating initial claims, leave revalidation, facilitating return-to-work efforts, coordinate employee payroll and time tracking while on leave, and working with work site managers and/or human resources personnel for workplace accommodations according to restrictions implemented by employees' treating physicians.

You will:

• Autonomously manage a dailytask listwithin turnaround time expectations.

• Investigate initial claims for approval underFMLA, PPL, STD (Preg/Maternity cases), and WC programs.

• Support Nurse Case Manager in administering leaves underSTD, LTD, FMLA, PPL, ADA, and WC Programs.

• Interpret and correctly apply provisions of STD, LTD, FMLA, PPL, ADA, and WC Plans.

• Determineif requested time-off is within acceptable guidelines. Request medical records from attending physician,completingnon-complexoutreach to physician offices,and consultingwith nursing staff.

• Supportthe Nurse Case Manager inthereturn-to-work process withtheemployee, human resources, supervisor, andthird-partyvendoruntilthe employee isreleasedtofull duty

• Assist LTD claimant with Social Security filing(s) and Medicare approval.Update LTD claims for Social Security Award status.Audit and sign-off on coworkers’ LTD calculation sheets.

• Coordinate pay on approved workers’ compensation cases with carrierandmaintainclaims in leave management systemDetermineandestablishaccuratecoding of unpaid (FMLA, ADA, WC)and paid (STD, PPL, LTD) leavesinHRISsystem.

• Ensureaccurateapplication of state offsets,maintainoffset calculators,and continuouslymonitor forany changes in offset amounts or the inclusion of new states.

• Coordinate with 3rdparty vendor for claim administration and lost time for Canadian leaves.

• AssisttheNurse Case Managerin gathering all case materialstopreparean appeal before theWelfare PlanCommittee.

• As needed, work withHRlegal department in drafting employeedisability communications.

• CompleteannualLTD audit.

• Perform Iron Mountain File archiving.

• Provides training and support to Managers for any leaves related issue.

• Deliversongoing training to HR Support Lineagents.

• Troubleshoots andassistswith leave management system;collaborate on resolution plans.

• Create, audit, anddistribute reports as needed.

• Triageand addressnon-clinicalJira tickets

• Managefax server documentsemail inbox (Absence Management,Workers’ Compensation, Fitness Center)

• Coordinateinvoices/bill payments

• Manageandschedule all meetings Draft and circulate meeting agendas and minutes

• Respond to all department subpoenas and requests for Absence Management documentation

• Complete all requests for disabilitypayinformation on state disability forms.

• Complete special projects, and travel, as assigned.This includes assisting with projects within the Benefits department.

Your Background

As aLeave Administrative Specialist, you have

• 5+yearsclaims processing experiences within an insurance company or third-party administrator.

• Experience intightlymanaging claims and administering services on self-insured accounts.

• Problem-solving ability.

• Excellent written and verbal communication skills for both counseling and meeting presentations.

• Excellent interpersonal skills and the ability to deal with all levels of management and employees onvery sensitiveand emotional issues.

• Experience with good customer service standards.

• Candidates need todemonstrateinvestigative and analytical skills, advanced written and verbal skills, a proven record in return-to-workprograms,andunderstanding the social security disability insurance program.

• Ability to work effectively within a team atmosphere.

• Excellent computer skills.

• Knowledge of benefit administration and/or similar administrative skills.

• Complete understandingand application ofall current plans and practices

• Ability to be completely objective and not easily swayed by the personal interest of unit administrators or individual employee claimants.

• Familiarity with STD, FMLA, LTD, WC, ADA,PPL, state offsets,OSHA & safety rules & guidelines.

Compensation:

The hourly wage range for this position is $32-$36 per hour. Actual compensation will be based on skills and experience as they relate to the job requirements and the location where you will be performing the job.

Location:

Employeesresidingwithin1hourdriving distance of Sheltonare required totravel to local office(s) as assigned, minimumfourdaysper week.Subject to change based onbusiness needs.

Sponsorship

Must be legally authorized to work in the US. Employerwill not sponsorpositionfor employment visa status now or in the future (ex. H-1B).