About this opportunity
Equiliem lists this Absence & Disability Case Specialist opportunity in wellesley hills, Massachusetts. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Absence & Disability Case Specialist
Location: Remote - U.S.
Schedule/Shift: Monday-Friday, 8:30 AM-5:00 PM EST
Pay: $30.50 per hour
Position Overview
The Absence & Disability Case Specialist administers employee leave and short-term disability cases while ensuring compliance with applicable federal and state employment laws. This role works with employees, employers, healthcare providers, HR partners, and other stakeholders to evaluate absence requests, coordinate accommodations, review disability claims, and make timely benefit determinations. The position requires strong knowledge of absence and disability management, excellent judgment, attention to detail, and the ability to manage routine and complex cases independently in a fast-paced environment.
Job Responsibilities
Administer leave programs and policies in accordance with applicable federal and state laws, including FMLA, ADA, USERRA, and the Pregnancy Discrimination Act.
Manage routine and complex short-term disability claims and make appropriate determinations regarding claim approval, denial, or further investigation.
Review claim payments and medical recommendations to determine the appropriate disposition of claims.
Establish and manage claim action plans to ensure timely, accurate, and efficient case resolution.
Facilitate interactive discussions with employees, healthcare providers, supervisors, and HR partners regarding leave and accommodation requests.
Document absence requests, accommodation activities, communications, and actions taken throughout the case lifecycle.
Interpret applicable contracts, policies, and procedures and ensure consistent and compliant claims practices.
Obtain medical and supporting documentation required to substantiate claims or absence requests.
Communicate with employees, employers, healthcare providers, attorneys, vendors, and other stakeholders by telephone and other appropriate channels.
Maintain confidentiality of protected health information and handle sensitive employee information in accordance with applicable privacy requirements.
Provide technical assistance to other claims staff and participate in special projects as assigned.
Work independently while collaborating effectively with internal teams and business partners.
Job Requirements
1-2 years of customer service or financial services experience.
Experience with claims, absence management, disability management, healthcare, insurance, third-party administration, employer leave administration, or carrier operations is preferred.
Ability to understand and interpret legal and medical terminology and apply that information when evaluating claims.
Strong mathematical skills for claim payment calculations and adjustments.
Strong research, analytical, critical thinking, problem-solving, and decision-making skills.
Strong computer skills, including proficiency with Microsoft Word, Excel, email, and standard business applications.
Excellent verbal and written communication skills.
Strong customer service and interpersonal skills.
Strong organizational and time-management skills with the ability to prioritize and manage multiple cases and projects.
Ability to work independently, exercise sound judgment, and make appropriate decisions.
Strong facilitation skills and ability to communicate effectively with diverse stakeholders.
Ability to work effectively in a fast-paced, service-oriented environment.
Strong attention to detail and accuracy in documentation, reporting, and communication.
Ability to handle confidential information professionally and appropriately.
Ability to work effectively with employees, clients, claimants, vendors, healthcare providers, and internal business partners.
Education
Bachelor's degree preferred but not required.
Work Experience
1-2 years of customer service or financial services experience required.
Claims, medical terminology, absence management, disability management, healthcare, insurance, TPA, employer leave administration, or carrier experience preferred.
About Equiliem
Equiliem believes in empowering success. It's our job to cultivate relationships that connect people and employers in a way that is inclusive, intelligent, and allows both to thrive.
Across the U.S., leading companies in healthcare, government, engineering, manufacturing, professional services, and energy rely on us for their workforce solutions. Our recruiting and HR services include contract and direct hire staffing, Payrolling/EOR, Independent Contractor Compliance, and Managed Services.
For almost 30 years, we've helped shape our industry. Today, we continue to research, ask questions, and continuously enhance the candidate journey and client experience.
Benefits
We offer a comprehensive benefits package to our employees, which includes:
Medical Insurance
Vision & Dental Insurance
Life Insurance
Matching 401(k)
Commuter Benefits
Employee Discounts & Rewards
Payroll Payment Options
Future Communication Consent By applying, you are providing consent for Equiliem to engage with you via phone calls, AI-generated calls, AI-generated text messages, standard text messages, and/or emails to share job opportunities. Consistent with our Privacy Policy, information obtained will not be shared with third parties for marketing or promotional purposes. Message frequency may vary for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You may reply STOP to cancel or HELP for assistance.
EEO Employer Equiliem is an equal opportunity employer. We do not discriminate or allow discrimination based on race, color, religion, creed, sex, age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Equiliem will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at (emailprotected) or .
Worksite address
wellesley hills, MA, 02481, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.