Disability Claims Specialist — FMLA/PFL Expert

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

Benefits offered by this job

Medical coverage

Parental leaves

401K plan

Training reimbursement

Vacation & holidays

Discretionary incentive

Job summary

Tata Consultancy Services is seeking an Absence Case Manager in the United States. You will review and adjudicate Disability/FMLA/PFL claims, analyze medical documentation, and determine benefits due while ensuring timely payments and adjustments.

The role requires 1+ year of relevant claims experience, familiarity with FINEOS, and strong communication and analytical skills to support clients and claimants effectively.

Qualifications

• 1+ year of Disability/FMLA/PFL claims or insurance claims experience.
• Experience working with FINEOS.
• Knowledge of disability insurance claims, benefits administration, offsets and deductions.
• Excellent oral and written communication, including presentation skills.

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 carrier and employer guidelines.
• Analyze, approve and authorize assigned claims and determine benefits due.
• Review cases with Not in good order and secure missing documentation.
• Communicate with claimants and clients to set expectations on the claims process.
• Review client deliverables, manage workload, and handle escalations.
• Determine benefits due and make timely payments/adjustments for various disabilities.
• Refer cases to Team Lead and clinical case management as needed.
• Manage day-to-day workload and address issues in peer reviews.
• Offer ideas for continuous improvement and service levels.
• Perform other duties or special projects as assigned.

Skills

Disability/FMLA/PFL claims

FINEOS

Medical terminology

Disability insurance claims

Communication skills

Analytical skills

MS Office

Adaptability

Education

Associateship

Tools

MS Office

Job description

Tata Consultancy Services is seeking an Absence Case Manager in the United States. You will review and adjudicate Disability/FMLA/PFL claims, analyze medical documentation, and determine benefits due while ensuring timely payments and adjustments.

The role requires 1+ year of relevant claims experience, familiarity with FINEOS, and strong communication and analytical skills to support clients and claimants effectively.