Ability Analyst

The Hartford

Ability Analyst managing PFML claims with analytical expertise and customer service at insurance company, ensuring timely and fair outcomes. Requires strong communication and compliance skills.

Posted 5/19/2026full-timeHartford • Connecticut, Florida, Texas • 🇺🇸 United StatesMid-LevelSenior💰 $46,222 - $52,900 per yearWebsite

About the role

Key responsibilities & impact

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
Escalate complex or high-risk claims to senior team members or management as appropriate
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

What you’ll need

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

Comp & perks

Paid Family Medical Leave

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

insurance claims adjudicationmedical terminologycompliance requirementsanalytical skillsproblem-solving skillsdecision-makingdocumentationclaims management systemsmultitaskingtime management

Soft Skills

interpersonal skillsteam-oriented mindsetcollaborationwritten communicationverbal communicationorganizational skillscritical thinkingcompassionate communicationevidence-based decision makingeducational skills

Certifications

Bachelor's degree