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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing ADA, PWFA, FMLA, and STD claims while ensuring compliance with federal and state regulations. Proficient in case management, conflict resolution, and effective communication with clients and employees.
Highest-signal resume keywords
ADA ComplianceFMLA ManagementShort Term Disability (STD) ClaimsMedical Documentation ReviewConflict Resolution
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims AdjudicationCase AssessmentRegulatory ComplianceLeave ManagementMedical Certification Analysis
Soft Skills
Interpersonal SkillsProblem-Solving SkillsEmotional IntelligenceNegotiation SkillsConfidentiality
Tools & Technologies
Paperless EnvironmentCase Management Software
Industry Keywords
Americans with Disabilities Act (ADA)Pregnancy Workers Fairness Act (PWFA)State-Specific Leave LawsDisability Case ManagementSelf-Insured STD Plans
About the role
Key responsibilities & impact- Serve as the primary subject matter expert and facilitator for the ADA interactive process and PWFA
- Oversee, manage, process, and adjudicate FMLA, state, company-specific leaves, and straightforward and complex STD claims
- Analyze FMLA requests and make determinations based on federal and state regulations
- Communicate with clients and claimants regarding all aspects of the claims process
- Guide employees and clients through the reasonable accommodation process and recommend approaches for ADA and PWFA claims
- Conduct case assessments and contact employees, managers, and HR by telephone or email
- Document factors supporting or inhibiting successful return to work against essential job functions and undue hardships
- Review relevant information and consult medical resources to confirm decisions and recommendations
- Analyze FMLA medical certifications and documentation while ensuring regulatory compliance timeframes
- Inform STD claimants about required documentation, timeframes, claim status, approvals, denials, and consults
- Determine return-to-work goals and support return-to-work planning between employees and supervisors
- Serve as primary case contact and communicate with employer representatives throughout the claim
- Follow operating procedures and training requirements
- Attend case management and disability management meetings and trainings
- Complete other assigned projects and tasks
Requirements
What you’ll need- Minimum 5+ years of direct experience managing Leaves, STD and ADA / PWFA claims or high-level disability case management
- Computer skills and ability to work primarily online in a paperless environment
- Strong interpersonal and helping skills
- Assessment and problem-solving skills
- Deep understanding of the Americans with Disabilities Act (ADA), Pregnancy Workers Fairness Act (PWFA), FMLA, and state-specific leave laws
- Experience managing self-insured Short Term Disability (STD) plans and company-specific paid and unpaid leave policies
- Ability to review and interpret medical documentation and translate clinical restrictions against essential job functions
- Exceptional conflict resolution and negotiation skills
- Ability to handle sensitive medical information with extreme confidentiality and empathy
- High degree of emotional intelligence and ability to manage stressful situations involving employee health and legal compliance
Benefits
Comp & perks- Equal Opportunity Employer
- Accommodation for applicants with disabilities during the recruitment process, as required
