Team Leader

Job Overview

This position involves managing and adjudicating claims related to the Americans with Disabilities Act (ADA). The Team Leader will oversee eligibility determinations, data collection, and coordination with multiple stakeholders to ensure accurate leave administration and compliance.

Key Responsibilities

• Manage standalone ADA claims processing and administration.
• Conduct eligibility assessments and entitlement reviews, gathering necessary data from employees, physicians, or employers via outbound calls, emails, fax, or system tools.
• Swiftly evaluate new ADA claims against relevant leave policies and determine initial claim decisions.
• Perform leave-related duties such as health condition recertification, tracking intermittent claims, confirming return to work, and returning phone calls.
• Keep systems updated with accurate leave statuses and maintain proper documentation for tracking purposes.
• Adhere to a business guideline of completing activities within five business days to comply with regulations.
• Handle absence management and claim adjudication in accordance with Federal, State, and company leave policies.
• Collaborate closely with claim specialists, support staff, quality assurance teams, Claims Unit Leaders, employees, employers, and medical offices.

Additional Information

This role emphasizes compliance with multiple regulatory requirements and involves interaction with various internal and external parties to ensure accurate claims administration and employee leave management.