Absence Claims Specialist

Media Riders Inc.; Jacksonville (FL); On-site; USD 55,000 - 70,000; Full time

Job summary

Media Riders Inc. seeks an Absence Claims Specialist to manage Short Term Disability (STD) claims and FMLA leave for group benefits clients.

You will work with employers, employees, healthcare providers, and HR partners to review claims and make benefit decisions, ensuring compliant and timely handling. The role requires applying duration guidelines, coordinating accommodations, and interpreting federal and state laws.

Qualifications

• Knowledge of FMLA, ADA, short-term disability, or leave administration.
• Experience interpreting medical and legal terminology.

Responsibilities

• Review Short Term Disability claims and make final approval or denial decisions.
• Calculate, approve, and adjust claim payments within limits.
• Administer integrated FMLA leave and STD claims, including complex cases.
• Interpret contracts and apply federal/state laws (FMLA, ADA, USERRA).
• Provide support to claims staff and communicate with claimants and providers.

Skills

Customer service

Analytical skills

Time management

Legal/medical terminology

Communication

Education

Associate or Bachelor's degree

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

Job description

Must be able to work an Eastern Time Zone Shift

Shift: 8:30am - 5pmEST

Absence Claims Specialist

Absence Claims Specialist manages Short Term Disability (STD) claims and FMLA leave for group benefits clients. The role works with employers, employees, healthcare providers, and HR partners. It reviews claims, makes benefit decisions, administers integrated leave and disability cases, and coordinates workplace accommodations in compliance with federal and state employment laws, so that claims are handled accurately, fairly, and on time.

Primary Responsibilities:

• Review Short Term Disability claims and make final approval or denial decisions based on policy provisions.
• Calculate, approve, and adjust claim payments within established limits.
• Apply duration guidelines and clinical and vocational recommendations to determine benefit periods.
• Administer integrated FMLA leave and Short Term Disability claims, including routine and complex cases.
• Interpret contracts and apply federal and state laws, including FMLA, ADA, USERRA, the Pregnancy Discrimination Act, and state disability plans.
• Facilitate the ADA interactive process with employees, supervisors, medical providers, and HR business partners.
• Advise employers and employees on leave rights, responsibilities, and procedures.
• Obtain supporting documentation and communicate with claimants, employers, physicians, hospitals, and attorneys.
• Develop claim action plans and document all contacts, requests, and decisions.
• Protect health information in accordance with HIPAA and company privacy standards.
• Provide support to claims staff and assist with special projects as needed.

Preferred Qualifications:

• Associate or Bachelor's degree.
• 1–2 years of customer service, financial services, or claims experience.
• Knowledge of FMLA, ADA, short-term disability, or leave administration.
• Experience at an insurance carrier, third-party administrator (TPA), employer leave program, or healthcare organization.
• Ability to interpret medical and legal terminology and use legal resources.
• Strong mathematical skills for benefit calculations and payment adjustments.
• Strong organizational, communication, and time management skills.
• Experience managing a varied caseload and multiple priorities in a fast-paced environment.
• Proficiency in Microsoft Outlook, Word, and Excel.