FML Claims Case Manager I Job at Guardian Life, Sacramento, CA

T2lCdXRKdUx0RjlNaGx6NmdnRDdoZDRkTGc9PQ==
  • Guardian Life
  • Sacramento, CA

Job Description

**Position Summary** Our contact center is known for delivering outstanding customer service experiences and we want to work with others that have a drive to be the best at what they do. The FML Leave manager is responsible for proactively managing Leave of Absence programs and individual FML cases based on plan provisions, state and federal guidelines, and established protocols. **You will** · Interact and consult with key partners including Clients, Claimants, Nurse and Disability Case Managers, Risk Management. · Administer claims within a variety of group sizes, but is primarily assigned core and middle market cases, and is responsible for ensuring all regulations and guidelines continue to be met through the duration of the claim. · Utilize problem solving, analytical, written, and verbal communication skills to deliver timely and appropriate leaves management decisions while providing superior customer service to all internal and external customers. · Maintain case oversight and acts as the critical communication link, in conjunction with the assigned Disability Case Manager where applicable, for all parties in FML client absence programs including employees, client company, health care providers and clinical partners. · Ensure legal compliance, provides timely notifications to employees and client companies, reviews documentation for approvals and denials, responds to periodic audits. · Make recommendations for second and third opinions, independently and when indicated and concurred with by the Manager. · Maintain FML and absence information in Absence Manager Software System, including comprehensive activity notes. · Provide reports detailing essential information on open and closed absences. · Manage intermittent occurrences in accordance with approved certifications and identifies trends or abuse patterns. · Identifies potentially fraudulent cases. · Communicate with claimants, plan holders, and physicians as needed for information needed for initial and ongoing leave management. **You have** · 4-year college degree preferred or equivalent work/education experience: · Minimum 1-4 years' experience working with group disability or absence management, medical disability services or similar preferred; knowledgeable of governing regulations and medical terminology. · Previous case management, customer service or call center experience desired. · Bi-Lingual a plus · Ability to clearly communicate claim decisions and contract language verbally and in written correspondence. · FMLA and Group Disability claim experience or group benefit product knowledge strongly preferred. · Regulatory and Compliance experience a plus · Understanding of medical terminology and medical conditions helpful · Strong interpersonal and PC skills (e.g., Microsoft Word & Excel) Education **Salary Range:** $40,960.00 - $61,435.00 The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation. **Our Promise** At Guardian, you'll have the support and flexibility to achieve your professional and personal goals. Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards. **Inspire Well-Being** As part of Guardian's Purpose - to inspire well-being - we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues. Explore our company benefits at . _Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits._ **Equal Employment Opportunity** Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law. **Accommodations** Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact applicant_accommodation@glic.com . **Current Guardian Colleagues: Please apply through the internal Jobs Hub in Workday.** Every day, Guardian helps our 29 million customers realize their dreams through a range of insurance and financial products and services. Our Purpose, to inspire well-being, guides our dedication to the colleagues, consumers, and communities we serve. We know that people count, and we go above and beyond to prepare them for the life they want to live, focusing on their overall well-being - mind, body, and wallet. As one of the largest mutual insurance companies, we put our customers first. Behind every bright future is a GuardianTM. Learn more about Guardian at guardianlife.com .

Job Tags

Full time, Contract work, Flexible hours,

Similar Jobs

Sedgwick

Sr. Auto Appraiser Job at Sedgwick

 ...Workplaces National Top CompaniesCertified as a Great Place to WorkFortune Best Workplaces in Financial Services & InsuranceSr. Auto Appraiser**PRIMARY PURPOSE** **:** To inspect, identify, and evaluate auto vehicles involved in a loss.**ESSENTIAL FUNCTIONS and... 

Krystal Restaurants

Assistant General Manager Job at Krystal Restaurants

 ..., HEALTH BENEFITS, and 401k, !Are you dedicated and ambitious? Come work with us. Work today, get paid tomorrow ! Our Assistant General Managers balance being a great leader with delivering WOW service to our guests. Krystal Assistant General Managers understand the... 

TransPecos Banks

BSA/AML/OFAC Officer Job at TransPecos Banks

 ...Job Description Job Title : BSA/AML/OFAC Officer This position is available as an on-site assignment or remote (within the San Antonio Region). Summary : Overall responsibility for risk management and compliance with federal and state banking laws and regulations... 

Design Your Freedom

Education & Training Specialist - Seeking Change (Remote) Job at Design Your Freedom

 ...eLearning & knowledge-based sector. You are an educator or corporate trainer who is a future-...  ...sector. Youll be in control of your remote workday, schedule your time and set your...  ..., or working for yourself in education consulting or coaching. You have excellent... 

Radias Health

Mental Health Support Specialist - (Day/Evening/Weekend/Overnight) Job at Radias Health

 ...Pat Rate: $20.87 or full-time weekends, $18.63 for all other shifts Location: Fully onsite Are you interested in helping...  ...join the Residential Support Services program . You'll be working in a home-like setting, supporting adults who have experienced significant...