Disability & FMLA Claims Specialist

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

Benefits offered by this job

Discretionary annual incentive

Medical coverage

Dental & Vision coverage

Disability planning & insurance

Auto & Home Insurance

Identity protection

Commuter benefits & training reimburse

Vacation & holidays

401K plan

Performance bonus

Student loan refinancing

Job summary

Tata Consultancy Services seeks an Absence and claims adjudication specialist to manage Disability/FMLA/PFL claims, interpret medical documentation, determine benefits due, and ensure timely payments and adjustments under applicable regulations.

Key duties include reviewing claims, medical records, approvals/denials, and providing clear communication with claimants and clients. Requires 1+ year of relevant claims experience and proficiency with FINEOS.

Qualifications

• 1+ year of Disability/FMLA/PFL claims or insurance claims experience.
• Experience working with FINEOS.
• Working knowledge of medical terminology and documents, including APS, Diagnostic Tests, Imaging Tests reports.
• Knowledge of disability insurance claims, benefits administration, offsets and deductions, disability duration and medical management practices (mandatory).
• Excellent oral and written communication, including presentation skills.
• Strong analytical, decision making, problem solving, and people management 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 on FMLA claims per guidelines.
• Determine benefits due and make timely payments/adjustments.

Skills

Disability claims experience

FMLA/PFL claims

FINEOS

Medical terminology

MS Office

Communication skills

Analytical skills

People management

Education

Associateship

Tools

FINEOS

MS Office

Job description

Tata Consultancy Services seeks an Absence and claims adjudication specialist to manage Disability/FMLA/PFL claims, interpret medical documentation, determine benefits due, and ensure timely payments and adjustments under applicable regulations.

Key duties include reviewing claims, medical records, approvals/denials, and providing clear communication with claimants and clients. Requires 1+ year of relevant claims experience and proficiency with FINEOS.