Specialist

·       Handle and administer Family & Medical Leave Act standalone (as well as other leave) claims and adhere to federal and state regulatory and/or company plan requirements and established FMLA workflow procedures 

·       Complete eligibility decisions and review for entitlement, gather pertinent data, when necessary, from employee or employer through outgoing calls, email or other supporting systems.

·       Promptly review new FMLA and other leave claims within regulatory timelines, evaluate against appropriate leave plans and make initial claim decision.

·       Perform leave administration tasks as required, including recertification of health condition, intermittent claim tracking, RTW confirmation, return phone calls, etc.

·       Update systems to accurately reflect leave status and ensure appropriate diary documentation exists

·       Business recommended TAT to complete the activity is up to 5 business days to maintain compliance measures

·       The position is expected to do absence management and adjudication on Federal, State and company leaves.

·       Interact with claim specialist, claim support specialist, QA, Claims Unit Leader (stateside supervisors), employees, employers/customer and physician’s office