To apply call HR Rashi at (phone hidden)

Basic Function

- Handle and administer Family & Medical Leave Act standalone (as well as other leave) claims and adhere to federal and

state regulatory and/or company plan requirements and established FMLA workflow procedures

- Complete eligibility decisions and review for entitlement, gather pertinent data when necessary, from employee, physicians office or employer through outgoing calls, email, fax or other supporting systems.

- Promptly review recent FMLA and other leave claims within regulatory timelines, evaluate against appropriate leave plans

and make initial claim decision.

- Perform leave administration tasks as required, including recertification of health condition, intermittent claim tracking, RTW

confirmation, return phone calls, etc.

- Update systems to accurately reflect leave status and ensure appropriate diary documentation exists

- Business recommended TAT to complete the activity is up to 5 business days to maintain compliance measures

- The position is expected to do absence management and adjudication on Federal, State and company leaves.

- Interact with claim specialist, claim support specialist, QA, Claims Unit Leader (stateside supervisors), employees,

employers/customer and physicians office





Essential Functions:

- Analyze, validate and process transactions as per Desktop procedures (L3 & L4)
- Analyze and research all discrepancies
- Research & Investigate and resolve outstanding items
- Determine eligibility, entitlement and applicable plan provisions while meeting timeliness goals
- Clear and accurate written and verbal communication (Mix of scripted/unscripted) with employee, employer & stateside

resources by email and outgoing calls

- Establish action plans for each file to bring claims to resolution
- Utilize internal and external specialty resources to maximize impact on each claim file
- Use PC programs to increase productivity and performance
- Ensure that the assigned targets are met in accordance with SLA, Performance Guarantee and Internal standards
- Ensure that the quality of transaction is in compliance with predefined parameters as defined by Process Excellence
- Work as a team member to meet office goals to obtain disabilitys vision while demonstrating core values and

meeting key measures

- Ensure adherence to established attendance schedules
- Close visual activity - viewing a computer terminal and extensive reading

📌 Claims Specialist - Operations (Noida)
🏢 Talent Advisors
📍 Noida