PFL Claims Specialist

This is a fully remote position, open to applicants in Nebraska, +2 more states.

📋 Description

• Conduct initial and ongoing interviews with claimants.

• Gather and evaluate medical records.

• Make timely and ethical determinations regarding claims.

• Communicate with claimants, employers, and medical professionals via phone and email to collect information related to Short Term Disability claims.

• Collaborate with case managers, nurse case managers, and consulting physicians on claim decisions.

• Analyze complex medical records to establish approval durations and future action plans.

• Execute accurate financial calculations in accordance with company and state regulations.

• Deliver outstanding customer service while proactively identifying customer needs and opportunities.

⛳️ Requirements

• High School diploma or GED.

• 1-2 years of experience in claims, leaves, or customer service.

• Strong written and verbal communication abilities.

• Excellent organizational skills with the capacity to manage multiple tasks simultaneously.

• Ability to juggle multiple priorities while handling a substantial volume of inbound and outbound calls.

• Experience in disability and/or absence management is a plus.

• Strong mathematical skills for payment calculations are advantageous.

🏝️ Benefits

• Clearly defined career paths and job levels.

• Opportunities for leadership development and virtual training.

• Paid time off and parental leave.

• Competitive 401K and employee benefits.

• Free financial counseling, health coaching, and employee assistance programs.

• Tuition assistance program.

• Flexible work arrangements tailored to your needs.

• Access to effective productivity and technology tools along with training.

• Eligibility for the Annual Incentive Program (discretionary).

• Long-term incentives may be available.

• Sales incentives may be available.

• Standard benefits package.