Paid Family & Medical Leave Claims Adjuster

Position Requirements:

• High school graduate required; BA/BS degree or relevant experience preferred.

• Self- motivated with the ability to work independently in a fast-paced environment with minimal supervision is necessary.

• Excellent customer services skills are important. There will be frequent interactions with employers and employees requesting leave.  The claim’s handler will need to interact with employers and their employees requesting leave benefits in a prompt, courteous, professional manner.

• Accurate claims adjudication by assessing all relevant information to determine compensability. The applicant will be expected to make decisions whether the leave request should be paid or denied in a timely fashion and communicate same to the appropriate parties.  If benefits are due, the applicant will be expected to calculate the accurate benefit payment and notify the proper parties in a timely manner.  If benefits are denied the decision will need to be communicated to the proper parties and respond to any appeals.

• Minimum 3 years experience handling disability and paid leave claims.

• Experience handling Massachusetts Paid Family and Medical Leave preferred.

• Stay up to date on changes in the leave law and best practices with leave programs and comply with all state mandated and contractual requirements.

• Detail oriented with highly developed organizational skills and ability to multitask required.

• Excellent analytical, problem-solving abilities required.

• Computer skills are important and should be proficient working in Adobe, Outlook, Excel, Word and not intimidated by learning new programs.

• Mathematical aptitude is necessary as the position will be required to calculate benefit payments for those cases that qualify.  Solid understanding of proper benefit calculation with knowledge of which offsets or coordination of benefits with other coverage may apply. These benefits will need to be calculated accurately and timely.

• Valid driver’s license, effective transportation and ability to attend onsite customer meetings as needed.

Primary Accountabilities:

• Be the first and founding employee in a new product line utilizing an entrepreneurial approach leading to professional success and growth.

• Ability to apply expertise and knowledge to the role as the workflow and functions become clearer as the law and it’s implementation go into effect and flexibility to adapt as they may change over time.

• Gains basic knowledge of Department Errors and Omissions Exposures and implementation of Department E&O Procedures.

• Ensures optimum performance in this function and recommends and implements techniques to increase productivity or department procedures. 

• Develops and maintains an image of corporate excellence and teamwork with emphasis on professional and credible customer service and company relations.

Positive and effective co-worker relations:

• Focus on team goals and objectives
• Courteous and considerate communications
• Accurate assistance and support to others as needed.

The above describes the primary functions of this position; however, should not be considered a detailed description of all assigned tasks.

Compensation: $75,000-$80,000