STAT PFL Claims Specialist

Stat PFL Claims Specialist

We are excited to bring on highly motivated Stat / PFL Claims Specialists to staff our ever-growing claims organization. As a Stat / PFL Claims Specialist, you will be responsible for conducting initial and ongoing interviews with claimants, obtaining, and reviewing medical records and making timely and ethical claim determinations. You'll complete a thorough training to develop new skills and give you the confidence you need to be successful in your new role. If you enjoy working in a fast-paced team environment for a high profile customer who values excellent customer service, then please read on!

Communicating with claimants, employers and various medical professionals through phone and e-mail to gather information regarding the Short Term Disability claim.

Collaborating with fellow case managers, nurse case managers and consulting physicians to make appropriate and timely claim determinations.

Reviewing complex medical records and effectively leveraging a variety of tools and resources to understand appropriate approval durations and future action planning.

Completing accurate financial calculations consistent with company and state guidelines.

Providing exceptional customer service and proactively recognizing customer needs and areas of opportunity.

Must haves:

• High School diploma or GED
• 1-2 years of experience in claims, leaves or customer service
• Strong written and verbal communication skills
• Excellent organization skills with the ability to multi-task
• Highly organized with proven ability to manage multiple priorities while handling a high volume of inbound and outbound calls

Nice to haves:

• Experience with disability and/or absence management
• Strong mathematical skills for payment calculations

Applications for this position will be accepted through July 2, 2026 subject to earlier closure due to applicant volume.