Senior Claims Specialist – Short Term Disability

Job Description: • Manage a diverse and often complex caseload of STD (Short Term Disability) claims from initial intake through resolution, ensuring timely, fair, and accurate decisions using sound judgment and adherence to policy provisions. • Collaborate with clinical and vocational partners to develop effective RTW strategies and determine appropriate benefit eligibility and durations. • Serve as a subject matter expert on STD claim practices, consulting on best practices and contributing to the design and refinement of internal procedures, workflows, and system requirements. • Leverage a deep understanding of disability contract provisions, exclusions, riders, waivers, and applicable regulatory and statutory requirements (e.g., FMLA, ERISA, HIPAA). • Ensure detailed and accurate documentation of all decisions and interactions, and communicate clearly with claimants, employers, and internal stakeholders. • Mentor and support onboarding of new team members; share expertise and foster knowledge growth within the team. • Collaborate cross-functionally with Compliance, Legal, Intake/Admin, Clinical and Vocational Services, and other business units to deliver a coordinated and compliant claims experience. • Proactively identify process gaps or opportunities and contribute to continuous improvement efforts and enterprise initiatives. • Demonstrate agility in adapting to changing priorities, business needs, and regulatory requirements. • Maintain a high level of confidentiality, professionalism, and integrity in all claim-related activities. Requirements: • College degree or equivalent experience preferred. • Minimum 5 years of experience handling Short Term Disability claims • Strong understanding of Short term Disability claim adjudication and relevant federal/state regulations (e.g., FMLA, ERISA, HIPAA, ADA). • Experience partnering with clinical/vocational professionals to support RTW efforts and complex decisioning. • Effective verbal and written communication skills with the ability to explain complex decisions clearly and empathetically. • Demonstrated problem-solving and analytical skills with a customer-first mindset. • Highly organized and detail-oriented with the ability to manage competing priorities. • Proven ability to mentor peers and support a collaborative team environment. • Proficiency with claims administration platforms and workflow/documentation tools. • Demonstrated ability to work independently and exercise sound judgment. • Growth mindset with a commitment to continuous learning and improvement. • Strong time management and the ability to thrive in a fast-paced, evolving environment. • Experience supporting cross-functional or enterprise initiatives and change management efforts. Benefits: • Your Benefits Start Day 1 • Prioritization of your health and well-being including Medical, Dental, Vision, and Wellbeing Reimbursement Account that can be used on yourself or your eligible dependents • Generous paid time off options including: Paid Time Off, Holiday Schedules, and Financial Planning Time Off • Paid Parental Leave as well as an Adoption Assistance Program • Competitive 401k savings plan with company match and an additional contribution regardless of participation Apply tot his job