Leave of Absence Representative

Sedgwick Claims Management Services Ltd; California, Northern (MO, KY); Hybrid; USD 26,000 - 37,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401k and matching

PTO

Disability and life insurance

Employee assistance

Job summary

Sedgwick is seeking a Leave Analyst in California to analyze FMLA and other state leave requests, determining benefits due under client plans and regulations. You will calculate payments, prepare adjustments, and support timely claim management.

Two years of disability management or FMLA experience is preferred, with strong communication and MS Office skills. The role emphasizes accuracy, collaboration, and adherence to workflows; starting pay noted for the jurisdiction is $23.00 per hour.

Qualifications

• High school diploma or GED required.
• State certification or licensing in statutory leaves is beneficial.
• Two (2) years disability management and/or FMLA administration experience or equivalent combination of education and experience required.
• FMLA administration experience preferred.
• Knowledge of state and federal FMLA regulations.
• Excellent oral and written communication, including presentation skills.
• Proficient computer skills including Microsoft Office.
• Analytical and interpretive skills.
• Strong organizational and multitasking skills.
• Excellent interpersonal skills.
• Ability to exercise judgement in accordance with well-defined policies and procedures.
• Ability to work in a team environment.
• Ability to meet or exceed performance competencies as required by program.

Responsibilities

• Establishes FMLA and other paid and unpaid state, military, and/or company-specific leave claims; tracks and codes documentation.
• Handles complex statutory components for leaves based on client needs.
• Analyzes FMLA and other complex paid and unpaid leave claims to determine eligibility, certification, payment calculations, payments and/or adjustments in compliance with client paid leave plans, policies, and state and federal regulations.
• Reviews claim information received to identify action plan, determine benefits due, and make timely case decisions based on plan descriptions and service expectations as established by the client.
• Communicates decisions and on-going expectations clearly and professionally with claimants and clients by phone, written correspondence and/or claims system.
• Maintains professional client relationships and provides excellent customer service.
• Meets the organization’s quality program(s) minimum requirements.
• Performs other duties as assigned.

Skills

FMLA regulations

Communication skills

MS Office

Analytical skills

Organizational skills

Interpersonal skills

Teamwork

Judgment & discretion

Education

High school diploma or GED

Statutory leaves certification (beneficial)

Job description

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance

PRIMARY PURPOSE

Analyzes reported leave requests including Family Medical Leave (FMLA), complex paid and unpaid state, military, and company-specific; to determine paid leave benefits due based on client paid leave plans, policies, state, and federal regulations; Makes timely and accurate calculations, payments and/or adjustments for client paid leave plans and ensures that on-going claim management is within company service standards and industry best practices.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Establishes FMLA and other paid and unpaid state, military, and/or company-specific leave claims; tracks and codes documentation in accordance with internal workflow processes.
• Handles complex statutory components for leaves based on client needs.
• Analyzes FMLA and other complex paid and unpaid leave claims to determine eligibility, certification, payment calculations, payments and/or adjustments in compliance with client paid leave plans, policies, and state and federal regulations.
• Reviews claim information received to identify action plan, determine benefits due, and make timely case decisions based on plan descriptions and service expectations as established by the client.
• Communicates decisions and on-going expectations clearly and professionally with claimants and clients by phone, written correspondence and/or claims system.
• Maintains professional client relationships and provides excellent customer service.
• Meets the organization’s quality program(s) minimum requirements.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

QUALIFICATIONS

Education & Licensing

• High school diploma or GED required.
• State certification or licensing in statutory leaves is beneficial.

Experience

• Two (2) years disability management and/or FMLA administration experience or equivalent combination of education and experience required.
• FMLA administration experience preferred.

Skills & Knowledge

• Knowledge of state and federal FMLA regulations.
• Excellent oral and written communication, including presentation skills.
• Proficient computer skills including working knowledge of Microsoft Office.
• Analytical and interpretive skills.
• Strong organizational and multitasking skills.
• Excellent interpersonal skills.
• Ability to exercise judgement in accordance with well-defined policies and procedures.
• Ability to work in a team environment.
• Ability to meet or exceed performance competencies as required by program.

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

• Mental: Clear and conceptual thinking ability; excellent judgment and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
• Physical: Ability to sit at a desk for extended periods while operating a computer and phone system. Travel as required. Auditory/Visual: Hearing, vision and talking.

COMPENSATION AND BENEFITS

A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

For the jurisdiction noted in this job posting only, the range of starting pay for this role is $23.00.

DEFINITIVE STATEMENTS

Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.

sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location.

For more, see sedgwick.com