Claims Examiner - Leave Administration
Pitney BowesAbout the role
We’re hiring at Pitney Bowes, where top talent builds meaningful careers and lasting impact. We Move fast, Deliver excellence, and Win together…that’s The Pitney Bowes way. Here, how we work matters just as much as what we achieve.
We’re looking for people who:
Act with urgency, accountability, and purpose
Deliver high quality work with consistency and pride
Collaborate effectively and elevate those around them
Focus on outcomes that drive impact and growth
Job Description:
You are:
The Leave Administation Specialist for non-occupational and workers' compensation leaves, responsible for the proactive management of claims. This includes investgating initial claims, leave revalidation, facilitating return-to-work efforts, coordinate employee payroll and time tracking while on leave, and working with work site managers and/or human resources personnel for workplace accommodations according to restrictions implemented by employees' treating physicians.
You will:
Autonomously manage a daily task list within turnaround time expectations.
Investigate initial claims for approval under FMLA, PPL, STD (Preg/Maternity cases), and WC programs.
Support Nurse Case Manager in administering leaves under STD, LTD, FMLA, PPL, ADA, and WC Programs.
Interpret and correctly apply provisions of STD, LTD, FMLA, PPL, ADA, and WC Plans.
Determine if requested time-off is within acceptable guidelines. Request medical records from attending physician, completing non-complex outreach to physician offices, and consulting with nursing staff.
Support the Nurse Case Manager in the return-to-work process with the employee, human resources, supervisor, and third-party vendor until the employee is released to full duty.
Assist LTD claimant with Social Security filing(s) and Medicare approval. Update LTD claims for Social Security Award status. Audit and sign-off on coworkers’ LTD calculation sheets.
Coordinate pay on approved workers’ compensation cases with carrier and maintain claims in leave management system. Determine and establish accurate coding of unpaid (FMLA, ADA, WC) and paid (STD, PPL, LTD) leaves in HRIS system.
Ensure accurate application of state offsets, maintain offset calculators, and continuously monitor for any changes in offset amounts or the inclusion of new states.
Coordinate with 3rd party vendor for claim administration and lost time for Canadian leaves.
Assist the Nurse Case Manager in gathering all case materials
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