🚀 Join Broadspire's Growing PMFL Team! 🚀 Are you an experienced Paid Medical & Family Leave (PMFL) Adjuster or Case Manager looking for your next opportunity? Broadspire is expanding and looking for professionals who are passionate about helping employees through important life events. 💙 Why Broadspire? ✅ Competitive compensation 🏠 Remote opportunities available 🤖 Advanced technology and AI-powered tools 🌟 Strong leadership support 📈 Career growth and development opportunities 🤝 Collaborative team environment 🏆 Backed by a nationally recognized organization If you have PMFL experience and are looking for a company that values your expertise, provides exceptional support, and offers opportunities to grow, we'd love to connect. 🎯 Make an impact 🎯 Grow your career 🎯 Join the future of leave administration with Broadspire • Manages assigned caseload of disability claims for Short Term/Long Term Disability. • Communicates with claimants, employers, and various medical professionals to gather information regarding eligibility, benefit authorization, and ongoing management of STD or LTD benefits. • Applies the appropriate contractual provisions; case management resources; and claim processes to ensure eligibility requirements and liability decisions are accurate. • Provides superior customer service by rendering benefit determinations within expected timeframes and quickly responding to all inquiries. • Demonstrates ability to independently manage disability claim and apply clinical guidance as provided on more complex claims. • Verifies on-going disability and participates in claim reviews with specialized resources including nurses, physicians, vocational rehabilitation, etc. to discuss return to work opportunities as appropriate. • Uses disability claim system to manage and authorize payment on claims while meeting all service, timeframe, and productions standards • Ensures a timely and appropriately coordinated transition of claims from STD to LTD, providing a well -managed and seamless claims experience to claimants. • Analyzes claims activity and prepares reports for clients/carriers and management as needed • Becomes familiar with specialized client instructions and performance guarantee standards for any assigned clients. Serves as a resource for trainees and Claims processors as needed. • Effectively works together in a team setting. • Other duties as assigned. • Bachelor's degree or equivalent experience required. • 2 + years of STD/LTD claims adjudication • Experienced in the TPA or self-administration services is desired • Experience with FMLA/State leave claims is a plus • Aptitude for learning medical terminology and conditions, as well as interpreting procedures and regulations • Ability to work independently while assimilating various technical resources • Computer knowledge in excel, word, web based systems, etc • Good verbal and written communication skills • Knowledge of ERISA regulations, required offsets and deductions, disability duration and Social Security procedures • Demonstrated ability to gather and analyze information, determine a course of action and implement the selected course of action. • Strong ability to identify, analyze and solve problems. • Effective interpersonal skills capable of dealing with external sources and all levels of employees. #LI-DV1