Disability & FMLA Claims Specialist

Tata Consultancy Services; Sugar Hill (GA); On-site; USD 48,000 - 55,000; Full time

Benefits offered by this job

Discretionary Incentive

Comprehensive Medical Coverage

401K Plan

Certification & Training Reimbursement

Vacation & Holidays

Job summary

Tata Consultancy Services is seeking a Disabilty/Claims Specialist in Sugar Hill, GA to manage Absence case management and claim adjudications based on medical documentation and FMLA/Paid Family Leave interpretations. You will determine benefits, make timely payments, and adjust as needed.

Responsibilities include reviewing medical information, approving or denying FMLA claims, and coordinating with claimants and clients to set expectations.

Qualifications

• Associateship required.
• Experience with Disability/FMLA/PFL claims or insurance claims.
• Experience with FINEOS.
• Knowledge of disability insurance claims and benefits administration.
• Strong communication and analytical skills.

Responsibilities

• Review and analyze claim nuances, eligibility and type of claims.
• Evaluate medical information to determine disability status.
• Approve or deny FMLA claims per guidelines.
• Determine benefits due and process timely payments/adjustments.
• Coordinate with team leads for escalations and improvements.

Skills

Disability insurance claims

FMLA/PFL knowledge

Medical terminology

Communication skills

MS Office

Analytical thinking

FINEOS

Education

Associateship

Tools

FINEOS

Job description

Tata Consultancy Services is seeking a Disabilty/Claims Specialist in Sugar Hill, GA to manage Absence case management and claim adjudications based on medical documentation and FMLA/Paid Family Leave interpretations. You will determine benefits, make timely payments, and adjust as needed.

Responsibilities include reviewing medical information, approving or denying FMLA claims, and coordinating with claimants and clients to set expectations.