Integrated Leave Specialist

7 days ago

Mount Laurel, New Jersey, United States Alera Group Full time
Job Title: Integrated Leave Specialist

Absolve Absence Solutions, an Alera Group Company, is seeking a highly skilled Integrated Leave Specialist to join our team in Mount Laurel, NJ.

About the Role:

The Integrated Leave Specialist will be responsible for ensuring accurate and timely processing and payment of all FMLA, New York Paid Family Leave, and New York and New Jersey Short-term Disability claims while providing an exceptional customer experience from start to finish.

Key Responsibilities:
  • Receive and triage incoming communications to determine the nature of callers' requests and which laws and insurance applications will apply
  • Takes accurate and detailed statements from all involved parties; collects all pertinent information from employees and enters that information accurately into the claims system
  • Verifies employee eligibility for coverage/benefits through a use of mixed resources and enters all pertinent information timely, completely, and accurately
  • Assists employees in navigating the disability/leave of absence claim process
  • Understands and respects the sensitivity and confidential nature of issues discussed and information handled
  • Exercises careful discretion and complete HIPAA compliancy when collecting, discussing, and documenting any/all customer information
  • Sends acknowledgement and authorization correspondence within legally required timeframes
  • Requests employee leave policy kits and any other necessary information from employers and third parties timely with consistent follow-up through to claim completion
  • Redirects quality of care/service complaints to Contact Center Manager only when absolutely necessary, using interpersonal skills to de-escalate negative conversation
  • Ensures all incoming claims are processed in accordance with regulatory requirements and adheres to mandated compliance timeframes
  • Responsible for handling mail, faxes, and voice mail messages on a daily basis
  • Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to applicable laws and policies as well as internal protocol and reporting requirements
  • Calculates and approves payment of claims within a certain monetary limit with 100% accuracy
  • Communicates claim action with claimant and client
  • Ensures claim files are properly documented and claims coding is correct
  • Coordinates with Management and senior staff in handling cases correctly
Requirements:
  • College degree from an accredited college and/or a minimum of three years general business or customer service experience is preferred in an insurance setting
  • Requires excellent investigative, analytical, and multi-tasking abilities in a fast-paced environment
  • Ability to maintain scheduled deadlines and work well with others as part of a cohesive team of caring individuals
  • Must exhibit strong skills in technology to include keyboarding and familiarity with word processing software, electronic communications, and Internet research capabilities
  • Excellent written and verbal communication skills
What We Offer:

We offer comprehensive benefits to employees, including medical, dental, STD, LTD, and life insurance, 401(k), paid time off, and much more.

We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

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