Leave Specialist, Integrated Absence & STD

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.  

Job Description:

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work.

The opportunity:

The Leave Specialist acts under the general supervision of a Senior Manager managing a caseload of FMLA, Paid Family Leave (PFL), ADA and other leave program claims. 

How you will contribute:

• Reviews and investigates FMLA, PFL, ADA and other leave claims by using telephone and written contact with the applicable parties (claimant, employer/supervisor, treating physician, etc.) to gather pertinent data to analyze the claim
• Adjudicates claims accurately and fairly in accordance with federal/state/local regulations, appropriate policies and procedures, meeting absence productivity and quality standards
• Utilizes appropriate medical and vocational or other resources, adhering to referral polices, and transferring claims to the appropriate risk level in a timely manner
• Develops and maintains on-line claim data
• Documents and communicates claim decisions
• Sends timely appropriate notifications according to communication preferences of claimant and employer
• Coordinates return to work, working with vocational rehabilitation consultant as necessary
• Coordinates placement of needed accommodations for client employees and claimants, working with employer, health care provider, and vocational rehabilitation consultant as needed
• Effectively adapts to change within the organization, department and industry
• Participates in in-service and training opportunities as required
• Other duties and responsibilities as needed

What you will bring with you:

• Exposure to various issues within FMLA and/or PFL with demonstrated experience in generating and selecting solutions to resolve those issues
• Solid analytical, critical thinking, problem solving and decision-making skills
• Ability to interpret and communicate FMLA/PFL/ADA and other leave regulation language
• Excellent verbal communication skills, with the ability to be both pleasant and professional
• Strong written communication skills
• Solid mathematical skills
• Ability to work well independently and in a team environment
• Strong interpersonal and customer service skills
• Ability to initiate and prioritize regular work duties and projects
• Detail oriented, organized, the ability to multi-task, and strong time management skills
• Strong computer skills, proficient in a PC environment and MS Word, Excel, and email systems
• Ability to work professionally and effectively with co-workers, clients, claimants, vendors and others with whom DRMS does business
• High School degree or equivalent
• Minimum 1 year previous FMLA and/or PFL experience
• While performing the duties of this job the employee is required to stand, move from one room to another, and frequently sit.  The employee must talk or listen, and use hands to finger, handle or touch in the context of navigating a computer keyboard and phone system.
• The employee must be able to understand the spoken word, written word, both hard-copy and on-line and must be able to respond in kind.
• The employee must be able to operate standard business equipment including a computer and a variety of software applications.
• TRAVEL REQUIRED: Limited

Salary Range: $52,500 - $70,900

At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for th