Leave Management Specialist - Human Resources * Days - 40hrs/wk
FTE status: 1
Under limited direction, the Leave Management Specialist is accountable for coordinating and processing claims activities for Maternity, Short-Term Disability (STD), FMLA, Medical, and Personal Leave of Absence claims per internal policy and legal requirements. The Leave Management Specialist reviews and coordinates claims; effectively communicates with claimant, management, and treatment providers, and processes payroll consistent with applicable Metro Health policies to ensure all leave claims are timely processed correctly.
- Bachelor’s Degree in Business Administration, Human Resources, Health management or closely related field.
- Three (3) years of experience administering leave management (STD/LTD/FMLA) with general welfare benefit experience strongly preferred
- Experience utilizing claims management software strongly preferred.
- Knowledge of benefits administration, including, but not limited to, IRS Code Section 125 regulations, COBRA, FMLA, ADA, HIPAA, IRS, FLSA regulations
- Proficient in MS Office (Word, Excel, Outlook)
- Certification as a Professional in Human Resources preferred.
- Strong verbal and written communication skills with all levels within and outside the organization
- Strong math skills with the ability to conduct complex analysis of claims, budget projections, etc.
- Strong reasoning ability in order to research complex questions / situations and formulate appropriate resolutions and recommended process changes.
Essential Functions and Responsibilities:
- Administers and coordinates integrated claims management involving Short Term Disability (STD), Long Term Disability (LTD), Maternity, Family Medical Leave Act (FMLA), Medical and Personal Leaves in accordance with the respective organization’s Plan Documents, policies and applicable laws that govern them.
- Coordinates integrated claims management with STD and LTD vendors to provide timely and accurate customer service. Investigates and follows up on abnormal and/or inconsistent activities with a claim.
- Serves as a liaison between treatment providers, ergonomic consultants, vendors, staff, management, and other HR staff to protect the rights of claimants/employees and reduce potential organizational exposure. Communicates with providers of medical treatment regarding qualifying reasons and anticipated length of leave/disability period.
- Collaborates, educates, advises, and maintains positive relationships between client groups, management, employees and human resources by serving as a liaison to procure specialty services (leave administration) such as notification of employees rights and reviewing requests for leaves while ensuring equitable treatment of employees. Identifies new or existing management employees who are in need of information/consultation regarding leaves and provides information accordingly.
- Facilitates effective communication between management and employees regarding leaves of absence to promote employee morale and maintain an environment conducive to controlling costs and increasing productivity consistent with applicable leave laws and Metro’s policies.
- Calculate and code hours owed into the payroll system for employees on leave. Answer employee questions and concerns regarding disability pay and/ salary continuation. Provides appropriate documentation into the IDM Claims management computer data base and the hardcopy files consistent with department standards.
- Manages restricted work program within the organization for disabled workers, in partnership with Employee Health. Oversees staff that are placed in temporary placements in or outside of their regularly assigned department to ensure restrictions and schedules are adhered to by the staff member and management.
- Maintains up to date knowledge of the laws and pertinent legal parameters pertaining to the administration of leaves, working closely with Legal Services.
- Performs other duties as assigned. These may include but are not limited to: Maintaining a current knowledge base of department processes, protocols and procedures, pursuing self-directed learning and continuing education opportunities, and participating on committees, task forces, and work groups as determined by management.