Leave of Absence Representative - Sedgwick Claims Management Services, Inc.

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. 

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

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Most Loved Workplace® 
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Leave of Absence Representative

Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence: Our West Hills Office is located at: 8521 Fallbrook Ave. Suite 250, West Hills, CA 9130

PRIMARY PURPOSE:  Analyzes reported leave requests including Family Medical Leave (FMLA), complex paid and unpaid state, military, and company-specific; to determine paid leave benefits due based on client paid leave plans, policies, state, and federal regulations; Makes timely and accurate calculations, payments and/or adjustments for client paid leave plans and ensures that on-going claim management is within company service standards and industry best practices.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Establishes FMLA and other paid and unpaid state, military, and/or company-specific leave claims; tracks and codes documentation in accordance with internal workflow processes.
• Handles complex statutory components for leaves based on client needs.
• Analyzes FMLA and other complex paid and unpaid leave claims to determine eligibility, certification, payment calculations, payments and/or adjustments in compliance with client paid leave plans, policies, and state and federal regulations.
• Reviews claim information received to identify action plan, determine benefits due, and make timely case decisions based on plan descriptions and service expectations as established by the client.
• Communicates decisions and on-going expectations clearly and professionally with claimants and clients by phone, written correspondence and/or claims system.
• Maintains professional client relationships and provides excellent customer service.
• Meets the organization’s quality program(s) minimum requirements.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.

QUALIFICATIONS

Education & Licensing

High school diploma or GED required.   State certification or licensing in statutory leaves is beneficial.

Experience
Two (2) years disability management and/or FMLA administration experience or equivalent combination of education and experience required. FMLA administration experience preferred.

Skills & Knowledge

• Knowledge of state and federal FMLA regulations
• Excellent oral and written communication, including presentation skills
• Proficient computer skills including working knowledge of Microsoft Office
• Analytical and interpretive skills
• Strong organizational and multitasking skills
• Excellent interpersonal skills
• Ability to exercise judgement in accordance with well-defined policies and procedures
• Ability to work in a team environment
• Ability to meet or exceed performance competencies as required by program

WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental:  Clear and conceptual thinking ability; excellent judgment and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Ability to sit at a desk for extended periods while operating a computer and phone system. Travel as required.

Auditory/Visual:  Hearing, vision and talking

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description   They are not intended to constitute a comprehensive list of functions, duties, or local variances.  Management retains the discretion to add or to change the duties of the position at any time.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (18.00 - 21.00). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.  

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.