US, GA - Atlanta, Atlanta
Position Type: 4
Job ID: 22-49848
Specialist, Claims Management (Disability)
Manage the day to day administration of the Disability and Leave Programs.
Responsible for the oversight of claims management and communication with employees, managers, attorneys, and Third-Party Administrator (TPA).
Serve as professional subject matter expert in the area of Disability, Leave (FMLA, Military, state, corporate) benefits to all divisions and departments eligible for the programs, to include but not limited to Human Resources, Corporate Safety, Labor Relations, Legal, and Operational/Station Management.
Proactively provide guidance and ongoing education to internal and external customers policies and procedures as it pertains to Disability, Leave and FMLA.
Assist in the education of internal business partners of the importance of early claim reporting, early return to work programs and other appropriate cost containment measures that will provide positive outcomes for all parties involved.
Identify trends in service concerns, recommend the appropriate course of action for improvement and development of vendor performance standards and adherence to contractual requirements. Ensure that claims handling is conducted in compliance with applicable regulations, corporate policies and other legal requirements.
Provide day-to-day oversight management of the TPA, interact with employees, associated providers, vendors, and defense counsel throughout the claims management process.
Practice safety-conscious behaviors in all operational processes and procedures.
Bachelors Degree or equivalent work experience and five years of direct Disability and Leave Claims Management and/or TPA vendor oversight experience is required. Must have the ability to prioritize their own work. Experience in Access, Excel, MS Office suite of products, and SAP is required. Ability to use Insurance Carrier/TPA data and claims management systems to analyze claim data. Must possess understanding of technical claims procedures relating to disability and leave benefits, as well as FMLA. Have good judgment in interpreting medical facts presented by a physician and applying these facts in determining disability and an employees ability to return to work. Excellent critical, logical-thinking, analytical, and research skills. Must demonstrate clear, concise, and effective oral and written communication skills. Convey moderately complex information (claim decisions, outcomes, etc.) to all appropriate parties, while maintaining a professional demeanor in all situations. Ability to perform effectively under pressure with minimal supervision and within strict deadlines. Ability to anticipate problems and suggest opportunities/solutions. Must possess ability to effectively interact with a variety of individuals within the company, clients, carriers, and vendor organizations. Must be versatile, resilient, responsive to change, and adapt to unexpected demands based on business needs. Should possess an overall knowledge of company policies and procedures. Must possess time management skills, multi-tasking skills, project management skills and organizational skills with attention to detail. Must be performing satisfactorily in current position.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. NLB is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. To request reasonable accommodation, contact HR department by sending an e-mail to email@example.com.