Disability Claims Specialist

Tata Consultancy Services; Eastover (SC); On-site; USD 48,000 - 55,000; Full time

Benefits offered by this job

Discretionary incentive

Comprehensive medical coverage

Parental leaves

401K plan

Certification & training reimbursement

Vacation & holidays

Job summary

Tata Consultancy Services in the United States, South Carolina, Eastover is seeking a claims professional to manage absence, FMLA/PFL, and related benefit adjudication tasks.

You will review medical information, determine eligibility, and approve or deny claims in line with carrier and employer guidelines. The role requires strong communication, analytical skills, and accuracy in processing payments and adjustments.

Qualifications

• 1+ year of Disability/FMLA/PFL claims or insurance claims experience.
• Experience with FINEOS.
• Working knowledge of medical terminology and documents.
• Knowledge of disability insurance claims, benefits administration, offsets and deductions, disability duration and medical management practices.
• Excellent oral and written communication, including presentation skills.
• Strong analytical, decision making, problem solving, and people management skills.
• Proficiency in MS Office (Excel, Word, PPT).
• Willingness to embrace change in a fast paced work environment.
• Identify escalated cases and work with Team Leader to develop a plan to address key issues.

Responsibilities

• Review and analyze claim nuances, eligibility review, and type of claims (intermittent or continuous).
• Review medical information to determine if the claimant is disabled as defined.
• Approve or deny FMLA claims per guidelines.
• Analyze, approve and authorize assigned claims and determine benefits due.
• Review client deliverables and manage workload and escalation.
• Determine benefits due and make timely payments and adjustments.

Skills

Disability/FMLA/PFL claims

FINEOS experience

Medical terminology

Communication skills

Analytical thinking

Education

Associate degree

Tools

MS Office

Job description

Tata Consultancy Services in the United States, South Carolina, Eastover is seeking a claims professional to manage absence, FMLA/PFL, and related benefit adjudication tasks.

You will review medical information, determine eligibility, and approve or deny claims in line with carrier and employer guidelines. The role requires strong communication, analytical skills, and accuracy in processing payments and adjustments.