Paid Family Medical Leave Analyst
The Hartford
full-time
Posted on:
Location Type: Hybrid
Location: Hartford • Connecticut, Florida • 🇺🇸 United States
Visit company websiteSalary
💰 $42,560 - $63,825 per year
Job Level
Mid-LevelSenior
About the role
- Independently manage a caseload of PFML claims from intake through resolution
- Conduct thorough reviews of medical records, employment history, and policy provisions
- Determine eligibility and benefit entitlement based on contractual language and supporting documentation
- Serve as the main contact for claimants, providing clear, compassionate, and timely updates
- Communicate with employers, physicians, and legal representatives to gather and clarify information
- Educate claimants on the PFML process, timelines, and expectations
- Make well-reasoned decisions supported by evidence and aligned with policy terms
- Document all claim activity, rationale, and communications in a clear and professional manner
- Prepare written correspondence including approval, denial, and status letters
- Collaborate with internal resources such as peers, CRO, SIU and Team Leader
- Ensure all claims are handled in compliance with State regulations, HIPAA, and other applicable regulations
- Participate in audits, quality reviews, and continuous improvement initiatives
Requirements
- Bachelor’s degree or equivalent work experience in insurance claims adjudication, healthcare, or a related field preferred
- THAA experience preferred
- Ability to understand State regulations, compliance requirements and medical terminology
- Ability to recognize red flags and escalate high-risk or potentially fraudulent claims appropriately
- Excellent analytical, organizational, and time management skills
- Proven ability to multitask effectively in a fast-paced, deadline-driven environment
- Demonstrated problem-solving skills with the ability to think critically and make sound decisions, drive solutions and overcome challenges
- Strong interpersonal skills and a team-oriented mindset, with the ability to collaborate across departments
- Exceptional written and verbal communication abilities
- Proficiency in claims management systems
Benefits
- 401K
- Medical
- Dental
- Vision
- Life and Disability Insurance
- 25 days paid time off in your first full year and Paid Holidays
- Tuition reimbursement - up to $5,250 (undergraduate) and $6,000 (graduate)
- Student Loan Paydown Program
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims adjudicationmedical terminologyanalytical skillsproblem-solving skillstime managementmultitaskingdecision-makingdocumentationcompliance understandingevidence-based decision making
Soft skills
interpersonal skillsteam-oriented mindsetcollaborationcommunication skillsorganizational skillscritical thinkingcompassionate communicationeducational skillsattention to detailadaptability