Ability Analyst, Paid Family Medical Leave

The Hartford

Insurance analyst adjudicating Paid Family and Medical Leave claims for The Hartford. Managing claimant communications, eligibility decisions, documentation, compliance, and escalations.

Posted 8/13/2026full-timeLake Mary • Connecticut, Florida • 🇺🇸 United StatesMid-LevelSenior💰 $48,071 - $76,267 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing PFML claims, ensuring compliance with state regulations and HIPAA, while effectively communicating with claimants and stakeholders. Proficient in claims management systems and skilled in analytical decision-making and problem-solving.

Highest-signal resume keywords

PFML Claims ManagementClaims AdjudicationState Regulations ComplianceAnalytical SkillsClaims Management Systems

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AdjudicationMedical TerminologyEligibility DeterminationDocumentationEvidence-Supported Decision MakingQuality ReviewsContinuous ImprovementProblem-SolvingMultitaskingTime Management

Soft Skills

Interpersonal SkillsCollaborationCommunication SkillsCompassionate CommunicationCritical Thinking

Tools & Technologies

Claims Management Systems

Industry Keywords

PFMLHIPAAInsurance ClaimsHealthcareCROSIUAudits

About the role

Key responsibilities & impact

Independently manage a caseload of PFML claims from intake through resolution
Review 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 and provide clear, compassionate, timely updates
Communicate with employers, physicians, and legal representatives to gather and clarify information
Educate claimants on the PFML process, timelines, and expectations
Make evidence-supported decisions aligned with policy terms
Document claim activity, rationale, and communications
Prepare approval, denial, and status letters
Collaborate with peers, CRO, SIU, and Team Leader
Escalate complex, high-risk, or potentially fraudulent claims
Ensure claims comply with state regulations, HIPAA, and other applicable requirements
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
Excellent analytical, organizational, and time management skills
Proven ability to multitask effectively in a fast-paced, deadline-driven environment
Demonstrated problem-solving skills and ability to think critically, make sound decisions, and drive solutions
Strong interpersonal skills and ability to collaborate cross-functionally
Exceptional written and verbal communication skills
Proficiency in claims management systems
Mandatory full-attendance training beginning on the start date
Start date of October 19, 2026

Benefits

Comp & perks

401K
Medical, Dental, Vision, Life and Disability Insurance effective day 1
25 days paid time off in your first full year
Paid Holidays
Tuition reimbursement up to $5,250 for undergraduate tuition and registration fees
Tuition reimbursement up to $6,000 for graduate tuition and registration fees
Student Loan Paydown Program after 6 months of service, with $125 per month and a lifetime maximum of $10,000
Short-term or annual bonuses
Long-term incentives
On-the-spot recognition
Award-winning well-being program