Position Summary
ADA Specialists/ ADA Consultant partner with the employee and employer to gather and communicate the facts about the accommodation need/request, substantiate the medical need for an accommodation, evaluate accommodation options/costs (including alternative options), & manage documentation and supporting material.
Job Responsibilities
Basic Function
Administer ADA (Americans with Disability Act) standalone claims
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 ADA, 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 physician’s 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 i
📌 Team Leader (Noida)
🏢 MetLife
📍 Noida