About the position
AbSolve Absence Solutions, an Alera Group Company is seeking an Integrated Claims Specialist - Leave of Absence/Disability to join our Mount Laurel, NJ team. This role will be hybrid after six months of in-office training. Absolve is a leading provider of absence and disability solutions for large employers. Our proprietary disability and claims management process provides employees with expert support during their leave. Rest assured that each employee's case will be managed consistently, in compliance with federal and state leave law. Our focus is creating healthier, more productive workforces by reducing the amount of time employees miss work due to unscheduled absences. When leaves are unavoidable, our team takes care of them from beginning to end. It is our commitment to make employees out on leave feel supported and ensure that they get their benefits as quickly and easily as possible. In a telephonic customer service environment, the Integrated Claims Specialist - Leave of Absence/Disability works as part of the claims team ensuring accurate and timely processing and payment of all FMLA, New York Paid Family Leave, as well as New York and New Jersey Short-term Disability claims while providing an exceptional customer experience from start to finish. Integrated Claims Specialist - Leave of Absence/Disability are the 'first response' for employees in need and must demonstrate a caring, responsive, and problem-solving attitude at all times while assigned to our Customer Service telephone queue. They are responsible for understanding and correctly communicating Federal and State leave laws and disability policy benefits to Human Resource partners and claimants.
Responsibilities
- Acts as the primary contact for employees initiating disability or leave claims; gathers detailed statements, verifies eligibility, and accurately enters information into the claims system.
- Receives and assesses incoming calls to determine the appropriate legal and insurance applications; ensures timely and accurate handling of inquiries and claim-related data.
- Assists employees in navigating the entire disability and leave process, ensuring clarity, compliance, and consistent follow-up with all parties involved.
- Maintains strict adherence to HIPAA guidelines, exercising discretion with all sensitive information, and ensures all communication meets legal timeframes.
- Approves and manages claims, calculates benefits, and processes payments accurately within defined monetary limits, following all relevant laws, policies, and protocols.
- Sends required documentation, requests employer-provided information, and works collaboratively with management and senior staff to ensure claims are resolved correctly.
- Handles mail, voicemails, and faxes daily; ensures claims are documented and coded properly, and takes responsibility for additional duties as assigned.
Requirements
- Claims experience (i.e. FMLA, LOA, or Disability)
- 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.
- Must possess high levels of fiduciary responsibility, self-accountability, attention to detail, and professionalism both over the telephone and in all written communications.
Benefits
- Medical insurance
- Dental insurance
- Life insurance
- Disability insurance
- 401k
- Generous paid time off
