To analyze reported Family Medical Leave (FMLA) requests; to make determinations based on state and federal regulations;
and to ensure that on-going claim management is within company service standards and industry best practices.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Establishes FMLA claims; tracks and codes documentation in accordance with internal workflow processes.
Analyzes FMLA claims to determine eligibility and certification in compliance with state and federal regulations.
Identifies action plan; determines benefits due; and makes timely case decisions based on service expectations as established by the client.
Communicates decisions and on-going expectations with claimants and clients.
Maintains professional client relationships.
Attendance during scheduled work hours is required.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
Education & Licensing
High school diploma or GED required. College degree and / or college courses preferred.
Two (2) years of administrative / general office experience or equivalent combination of education and experience required.
Disability management and / or FMLA administration experience preferred.
Skills & Knowledge
Knowledge of state and federal FMLA regulations
Knowledge of medical disability management
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies