Remote Claims Specialist

Corporate Brokers, LLC (Tential); United States; Remote; USD 40,000 - 60,000; Full time

Job summary

A leading claims management firm is seeking a Remote Claims Specialist to manage a caseload of leave program claims. The ideal candidate should have at least one year of experience with FMLA and/or PFL claims, along with strong analytical and decision-making skills. Responsibilities include reviewing claims, ensuring compliance with regulations, and coordinating accommodations for return-to-work processes. This role offers a dynamic working environment adhering to quality standards.

Qualifications

• Minimum of 1 year experience with FMLA and/or PFL claims.
• Exposure to issues within FMLA and/or PFL with experience in generating solutions.

Responsibilities

• Review and investigate claims related to FMLA, PFL, and ADA.
• Adjudicate claims in compliance with regulations and policies.
• Document claim decisions and coordinate necessary accommodations.

Skills

Strong analytical and decision-making skills

Proficiency in a PC environment

Experience with FMLA and/or PFL claims

Education

High School degree or equivalent

Tools

MS Word

Excel

Job description

A company is looking for a Remote Claims Specialist who will manage a caseload of leave program claims.

Key Responsibilities

• Review and investigate claims related to FMLA, PFL, and ADA, gathering data from relevant parties
• Adjudicate claims in compliance with regulations and policies, ensuring productivity and quality standards are met
• Document claim decisions and coordinate necessary accommodations and return-to-work processes

Required Qualifications

• High School degree or equivalent
• Minimum of 1 year experience with FMLA and/or PFL claims
• Exposure to issues within FMLA and/or PFL with experience in generating solutions
• Strong analytical and decision-making skills
• Proficiency in a PC environment, including MS Word and Excel