HumanEdge
Lead Leave Management Specialist (Valhalla)
HumanEdge, Valhalla, New York, United States, 10595
Opportunity Description
Lead Leave Management Specialist is responsible for the non-Occupational, Workers Compensation and assistance with the operations of the department to ensure efficiency and that the on-going claim management is within organizational standards and in compliance with state and federal regulations.
Company Information Hospitals & Healthcare
Job Duties Oversee and provide total leave of absence claim management - from first notice and intake to closure. Obtain and review updated medical evidence of reason for leave upon receipt for assigned claims. Review guidelines for eligibility resulting in accurate eligibility decisions. Handles more complex leave cases requiring use of sound judgement, based on knowledge, skills, and prior experience Serve as the point of contact for LOA Administrators, Management, Human Resources, Legal, and plan vendors regarding leaves of absence related processes. Provide support to Leave of Absence Specialists and training on appropriate procedures for all types of leaves. Responsible for LM Network training including updating LM Process Training Manual for new hires. Responsible for training staff on new systems and documentation of process. Maintain accurate records and reporting of employee leaves in full legal compliance. Develop, generate, and present reports to analyze leave data and trends including current leaves, returns from leaves, and intermittent leave implications (staffing, return to work, etc.). Create and manage dashboard reports for management review. Serve as the subject matter expert for the leave program in alignment and under the general direction and guidance of the Manager of Leave Management Ensures highest level of customer service with supervisors/managers and provides responsive support throughout LOA process. Review, update, and maintain knowledge of all LOA policies to ensure legal compliance, ensure proper distribution, and integration with all other departments Oversee integration of leaves (i.e. workers compensation with FMLA) and integration with other functions (benefits during LOA, payroll, etc.). Takes part in continuing education on LOA topics and ensures 100% federal and state compliance in all areas in which the organization operates. Acts as the primary point of contact for each injured employee for the duration of their workers compensation claim; acts as liaison between injured employee and workers compensation adjuster; and follows up with injured employee as needed to ensure claim is progressing properly. Analyze and process workers compensation claims by investigating and gathering information to determine compensability and exposure. Investigate claims to determine an injured workers entitlement to Workers Compensation benefits; administers indemnity and medical benefits for valid Workers Compensation claims. Responsible for receiving, organizing, and analyzing all files and documents related to the injured worker and the injury in order to make an effective and accurate determination concerning the claim. Perform interview with the injured employee to obtain a detailed description of how the injury occurred. Perform other duties as assigned or required
Education Bachelors Degree Required
Experience & Skills Required 3 years of extensive administrative experience and a background providing comprehensive support in Leave Management. Experience compiling and analyzing large volumes of information and streamlining processes/tasks to maximize productivity. Communicator possessing advanced technology skills with ability to prioritize multiple assignments in high volume, fast-paced environment while meeting deadlines Highly organized and able to think systematically to structure the work and design in a logical flow. Demonstrated proficiency in MS Office products (Word/Excel), internet, and website navigation required. Energetic, driven personality with a demonstrated ability to take initiative, successfully handle and prioritize multiple competing assignments and effectively manage deadlines. Outstanding verbal and written communication skills required with the ability to successfully interact at all levels of the organization while functioning as a team player.
Company Information Hospitals & Healthcare
Job Duties Oversee and provide total leave of absence claim management - from first notice and intake to closure. Obtain and review updated medical evidence of reason for leave upon receipt for assigned claims. Review guidelines for eligibility resulting in accurate eligibility decisions. Handles more complex leave cases requiring use of sound judgement, based on knowledge, skills, and prior experience Serve as the point of contact for LOA Administrators, Management, Human Resources, Legal, and plan vendors regarding leaves of absence related processes. Provide support to Leave of Absence Specialists and training on appropriate procedures for all types of leaves. Responsible for LM Network training including updating LM Process Training Manual for new hires. Responsible for training staff on new systems and documentation of process. Maintain accurate records and reporting of employee leaves in full legal compliance. Develop, generate, and present reports to analyze leave data and trends including current leaves, returns from leaves, and intermittent leave implications (staffing, return to work, etc.). Create and manage dashboard reports for management review. Serve as the subject matter expert for the leave program in alignment and under the general direction and guidance of the Manager of Leave Management Ensures highest level of customer service with supervisors/managers and provides responsive support throughout LOA process. Review, update, and maintain knowledge of all LOA policies to ensure legal compliance, ensure proper distribution, and integration with all other departments Oversee integration of leaves (i.e. workers compensation with FMLA) and integration with other functions (benefits during LOA, payroll, etc.). Takes part in continuing education on LOA topics and ensures 100% federal and state compliance in all areas in which the organization operates. Acts as the primary point of contact for each injured employee for the duration of their workers compensation claim; acts as liaison between injured employee and workers compensation adjuster; and follows up with injured employee as needed to ensure claim is progressing properly. Analyze and process workers compensation claims by investigating and gathering information to determine compensability and exposure. Investigate claims to determine an injured workers entitlement to Workers Compensation benefits; administers indemnity and medical benefits for valid Workers Compensation claims. Responsible for receiving, organizing, and analyzing all files and documents related to the injured worker and the injury in order to make an effective and accurate determination concerning the claim. Perform interview with the injured employee to obtain a detailed description of how the injury occurred. Perform other duties as assigned or required
Education Bachelors Degree Required
Experience & Skills Required 3 years of extensive administrative experience and a background providing comprehensive support in Leave Management. Experience compiling and analyzing large volumes of information and streamlining processes/tasks to maximize productivity. Communicator possessing advanced technology skills with ability to prioritize multiple assignments in high volume, fast-paced environment while meeting deadlines Highly organized and able to think systematically to structure the work and design in a logical flow. Demonstrated proficiency in MS Office products (Word/Excel), internet, and website navigation required. Energetic, driven personality with a demonstrated ability to take initiative, successfully handle and prioritize multiple competing assignments and effectively manage deadlines. Outstanding verbal and written communication skills required with the ability to successfully interact at all levels of the organization while functioning as a team player.