Leave of Absence Representative

Sedgwick•West Hills, CA

4d•Onsite

About The Position

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance. This role analyzes reported leave requests including Family Medical Leave (FMLA), complex paid and unpaid state, military, and company-specific leaves to determine paid leave benefits due based on client paid leave plans, policies, state, and federal regulations. The representative makes timely and accurate calculations, payments, and/or adjustments for client paid leave plans and ensures that on-going claim management is within company service standards and industry best practices.

Requirements

High school diploma or GED required.
Two (2) years disability management and/or FMLA administration experience or equivalent combination of education and experience required.
Knowledge of state and federal FMLA regulations
Excellent oral and written communication, including presentation skills
Proficient computer skills including working knowledge of Microsoft Office
Analytical and interpretive skills
Strong organizational and multitasking skills
Excellent interpersonal skills
Ability to exercise judgement in accordance with well-defined policies and procedures
Ability to work in a team environment
Ability to meet or exceed performance competencies as required by program

Nice To Haves

State certification or licensing in statutory leaves is beneficial.
FMLA administration experience preferred.

Responsibilities

Establishes FMLA and other paid and unpaid state, military, and/or company-specific leave claims; tracks and codes documentation in accordance with internal workflow processes.
Handles complex statutory components for leaves based on client needs.
Analyzes FMLA and other complex paid and unpaid leave claims to determine eligibility, certification, payment calculations, payments and/or adjustments in compliance with client paid leave plans, policies, and state and federal regulations.
Reviews claim information received to identify action plan, determine benefits due, and make timely case decisions based on plan descriptions and service expectations as established by the client.
Communicates decisions and on-going expectations clearly and professionally with claimants and clients by phone, written correspondence and/or claims system.
Maintains professional client relationships and provides excellent customer service.
Meets the organization’s quality program(s) minimum requirements.
Performs other duties as assigned.