Qureos Mentor

Crawford & Company

<div>Under general supervision of the Team Manager, the Leave Specialist is responsible for administering various clients' Family Medical Leave Act (&quot;FMLA&quot;) policy and performing various clerical duties to support the administration and operational functions of the unit.<ul>
<li>Assists associates with Leave of Absence (&quot;LOA&quot;) requests and guides them through the process.</li>
<li>Processes all LOA paperwork according to established procedures and laws.</li>
<li>Provides timely and accurate responses to associates and all levels of management concerning day-to-day issues and activities.</li>
<li>Administers the FMLA policy.</li>
<li>Reviews FMLA documentation for accuracy and completeness.</li>
<li>Makes recommendations to approve or deny requests for FMLA based on federal regulations.</li>
<li>Conducts FMLA training for Department supervisors and employees.</li>
<li>Coordinates correspondence, forms and other documents via the claim system.</li>
<li>Generates reports as required.</li>
<li>Maintains files.</li>
<li>Assists management with LOA situations and provides guidance within the policy and established legal guidelines.</li>
<li>Keeps complete records of all LOA requests and maintains tracking and analysis of data.</li>
<li>Participates in developing goals, objectives, and systems.</li>
<li>Maintains compliance with standards and federal/state regulations.</li>
<li>Serves as an internal reference to the team for certification requirements and processing.</li>
<li>Contacts Providers for clarification.</li>
<li>Inputs and analyzes data.</li>
<li>Supports management with special projects as necessary.</li>
<li>Upholds the Crawford Code of Conduct.</li>
</ul><ul><li>Associate's degree or equivalent combination of education and experience.</li>
<li>2-5 years of FMLA claim administration or a related field.</li>
<li>Current experience in the integrated disability and absence management industry.</li>
<li>Excellent customer service skills and ability to manage difficult and stressful situations.</li>
<li>Strong communication skills &mdash; written, verbal, persuasion, motivation, facilitation of strong working relationships.</li>
<li>Ability to manage business expectations and resolve concerns, by communicating status and issues.</li>
<li>Ability to effectively prioritize and escalate customer issues.</li>
<li>Ability to interpret and analyze multiple facts.</li>
<li>Must have a solid understanding of FMLA and employment.</li>
<li>Must complete continuing education requirements as outlined by Crawford Educational Services.</li>
</ul>
#LI-DV1
Why Crawford?
 
 
Because a claim is more than a number &mdash; it&rsquo;s a person, a child, a friend. It&rsquo;s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community &ndash; one claim at a time.
 
 
At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We&rsquo;re looking for the next generation of leaders to take this journey with us.
 
 
We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com.
 
 
When you accept a job with Crawford, you become a part of the One Crawford family.
 
 
Our total compensation plans provide each of our employees with far more than just a great salary
 
<ul><li>Pay and incentive plans that recognize performance excellence</li>
<li>Benefit programs that empower financial, physical, and mental wellness</li>
<li>Training programs that promote continuous learning and career progression while enhancing job performance</li>
<li>Sustainability programs that give back to the communities in which we live and work</li>
<li>A culture of respect, collaboration, entrepreneurial spirit and inclusion</li>
</ul>Crawford &amp; Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford &amp; Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.</div>

Leave Specialist

<div>The Disability Benefit Specialist will be relied upon to obtain and evaluate information in order to determine eligibility of benefits. Must be able to demonstrate a general knowledge of disability contracts, policies, and products and continued understanding of medical and vocational issues. Uses disability claims system for timely and accurate claims review, and effective communication of rationale for claims action. Communicates decisions effectively verbally and in writing to impacted parties such as Employees and Employers. Establishes future action plans and forms strategies for return to work based on the utilization of medical management resources, including the Client Advocate.<ul>
<li>Manages assigned caseload of disability claims for Short Term/Long Term Disability.</li>
<li>Communicates with claimants, employers, and various medical professionals to gather information regarding eligibility, benefit authorization, and ongoing management of STD or LTD benefits.</li>
<li>Applies the appropriate contractual provisions; case management resources; and claim processes to ensure eligibility requirements and liability decisions are accurate.</li>
<li>Provides superior customer service by rendering benefit determinations within expected timeframes and quickly responding to all inquiries.</li>
<li>Demonstrates ability to independently manage disability claim and apply clinical guidance as provided on more complex claims.</li>
<li>Verifies on-going disability and participates in claim reviews with specialized resources including nurses, physicians, vocational rehabilitation, etc. to discuss return to work opportunities as appropriate.</li>
<li>Uses disability claim system to manage and authorize payment on claims while meeting all service, timeframe, and productions standards</li>
<li>Ensures a timely and appropriately coordinated transition of claims from STD to LTD, providing a well -managed and seamless claims experience to claimants.</li>
<li>Analyzes claims activity and prepares reports for clients/carriers and management as needed</li>
<li>Becomes familiar with specialized client instructions and performance guarantee standards for any assigned clients. Serves as a resource for trainees and Claims processors as needed.</li>
<li>Effectively works together in a team setting.</li>
<li>Other duties as assigned.</li>
</ul><ul><li>Bachelor's degree or equivalent experience required.</li>
<li>2 + years of STD/LTD claims adjudication</li>
<li>Experienced in the TPA or self-administration services is desired</li>
<li>Experience with FMLA/State leave claims is a plus</li>
<li>Aptitude for learning medical terminology and conditions, as well as interpreting procedures and regulations</li>
<li>Ability to work independently while assimilating various technical resources</li>
<li>Computer knowledge in excel, word, web based systems, etc</li>
<li>Good verbal and written communication skills</li>
<li>Knowledge of ERISA regulations, required offsets and deductions, disability duration and Social Security procedures</li>
<li>Demonstrated ability to gather and analyze information, determine a course of action and implement the selected course of action.</li>
<li>Strong ability to identify, analyze and solve problems.</li>
<li>Effective interpersonal skills capable of dealing with external sources and all levels of employees.</li>
</ul>
#LI-DV1
Why Crawford?
 
 
Because a claim is more than a number &mdash; it&rsquo;s a person, a child, a friend. It&rsquo;s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community &ndash; one claim at a time.
 
 
At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We&rsquo;re looking for the next generation of leaders to take this journey with us.
 
 
We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com.
 
 
When you accept a job with Crawford, you become a part of the One Crawford family.
 
 
Our total compensation plans provide each of our employees with far more than just a great salary
 
<ul><li>Pay and incentive plans that recognize performance excellence</li>
<li>Benefit programs that empower financial, physical, and mental wellness</li>
<li>Training programs that promote continuous learning and career progression while enhancing job performance</li>
<li>Sustainability programs that give back to the communities in which we live and work</li>
<li>A culture of respect, collaboration, entrepreneurial spirit and inclusion</li>
</ul>Crawford &amp; Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford &amp; Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.</div>

Disability Benefit Specialist

Join Crawford & Company and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Crawford & Company

ABOUT_COMPANY

Leave Specialist

Disability Benefit Specialist