Absence Integrated Specialist

Location: Wellesley MA

Onsite Flexibility: Remote open to anyone in the U.S. as long as they can work EST hours

• Position Type: Contract
• Contract Duration: 6 months (with potential for extension)
• Pay Rate: $30.00 / Hour (USD)
• Shift / Schedule: Monday Friday 8:30 AM 5:00 PM EST
• Work Authorization: Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.

The Absence & STD Consultant works with employers employees and health care providers to administer an integrated Family and Medical Leave Act (FMLA) rights and responsibilities and Short Term Disability claim. Provides advice and counsel regarding leave administration and effectively coordinates all cases/claims in compliance with the FMLA and all related employment laws. Responsible for the professional management of both routine and complex claims for Group Short Term Disability while working both independently and in a team to ensure superior service to policyholders and claimants. Reviews claims and makes final determination for admittance or denial. Approves payment of claims and Company liability within established limits.

• Interprets and administers leave programs and policies in accordance with the applicable federal and state employment laws (FMLA ADA USERRA Pregnancy Discrimination Act etc.).
• Facilitation and engagement in interactive dialogue with employees medical professionals supervisors and HR business partners to assist employees.
• Documentation of the request for absence including detailed points of contact and actions taken to coordinate the accommodation request.
• Reviews claim payments within established limits and/or reviews recommendations made by medical resources to determine proper disposition of claims.
• Sets claim action plan to ensure that determinations are adjudicated in a timely accurate and efficient manner.
• Interprets contracts and ensures consistent fair claims practices and adherence to appropriate laws regulations and procedures.
• Obtains backup documentation as necessary to substantiate claim or to provide service by communicating via telephone with agents employers (policyholders) claimants hospitals physicians attorneys and other resources.
• May handle other related duties such as providing technical assistance to other Claims staff or assisting in special projects or assignments as a result of business needs.
• Protect and maintain personal health information with a high level of confidentiality abiding by Sun Life procedures and by HIPAA rules and regulations.
• Other duties and responsibilities as assigned.

• Possesses excellent Disability and Absence Management knowledge with demonstrated expertise in Federal/State FMLA short-term disability statutory disability plans and ADA.
• Effective ability to use legal resources and demonstrate a proven ability to comprehend and interpret legal and medical terminology in order to make final decisions to approve or further investigate claims.
• Strong computer skills proficient in PC environment and MS Word Excel and email systems.
• Demonstration of strong mathematical skills for calculations and adjustment of claim payments.
• Communicating effectively and professionally with a wide variety of both internal and external business partners peers and resources.
• Attention to detail with documentation reporting and communication.
• Facilitation skills in a variety of circumstances and with a wide variety of input; ability to influence and teach.
• Self-directed with an ability to work independently and make independent judgments and decisions.
• Strong organizational skills including the ability to prioritize work and multi-task.
• Strong research analytical critical thinking problem-solving and decision-making skills.
• Ability and desire to work in a fast-paced service-oriented environment.
• Excellent verbal communication skills with the ability to be both pleasant and professional.
• Strong written communication skills.
• Strong interpersonal and customer service skills.
• Ability to initiate and prioritize regular work duties and projects.
• Detail oriented organized the ability to multi-task and strong time management skills.
• Ability to work professionally and effectively with co-workers clients claimants vendors and others.

• Healthcare insurance TPA employer leave administration or carrier experience preferred.
• Claims background and medical terminology.

• Bachelors degree (preferred).

• 12 years of customer absence and claims services experience.

• 6 weeks of training provided upon start.
• Must be able to work EST hours (Monday Friday 8:30 AM 5:00 PM).

• Medical Vision and Dental Insurance Plans
• 401k Retirement Fund

• Claims experience is ideal particularly with short-term disability or medical claims; client-facing experience is also applicable.
• Candidates must be empathetic and strong problem solvers.

This client is a leading global financial services organization operating in insurance investments and asset management with a presence serving customers across the United States and internationally. With a large workforce spanning thousands of professionals the organization employs specialists across claims administration absence management disability consulting financial services and operations roles who collaborate to deliver superior service to employers and policyholders.

GTT is a minority-owned staffing firm and a subsidiary of Chenega Corporation a Native American-owned company in Alaska. We highly value diverse and inclusive workplaces and support Fortune 500 organizations across banking financial services technology life sciences biotech utilities and retail sectors throughout the U.S. and Canada.

Job Number: 26-14851