[Remote] Absence Management Specialist

Note: The job is a remote job and is open to candidates in USA. Reliance Matrix is dedicated to fostering an inclusive culture and is seeking an Absence Management Specialist. This role involves acting as a liaison between clients, employees, and healthcare providers, managing claims, and ensuring compliance with regulations while providing excellent customer service.

Responsibilities

• Investigates claim issues providing resolution within departmental and regulatory guidelines
• Interprets and administers contract provisions: eligibility and duration
• Accurately codes all system fields with correct financial, diagnosis and duration information
• Coordinates with other departments to ensure appropriate claims transition or facilitate timely return to work
• Adheres to compliance, departmental procedures, and Unfair Claims Practice regulations
• Actively contributes to customer service, quality and performance objectives
• Proactively engages in departmental training to remain current with all claim management practices
• Responsible for managing Performance Guarantee clients and meet targeted metrics
• Responsible and accountable for maintaining and protecting personal health information
• Must maintain a high level of confidentiality and abide by HIPPA rules and regulations

Skills

• High School Diploma or GED (Bachelor's preferred)
• Ability to develop proficiency regarding required RSL products, systems and processes related to the effective delivery of new business proposals
• Microsoft Office experience
• Attention to detail, analytical skills, and the ability to collaborate with others and work independently
• Strong organizational skills, including the ability to prioritize work and multi-task
• Customer service experience and orientation
• Written and verbal communication skills

Benefits

• An annual performance bonus for all team members
• Generous 401(k) company match that is immediately vested
• A choice of three medical plans (that include prescription drug coverage) to suit your unique needs.
• For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account
• Multiple options for dental and vision coverage
• Company provided Life & Disability Insurance to ensure financial protection when you need it most
• Family friendly benefits including Paid Parental Leave & Adoption Assistance
• Hybrid work arrangements for eligible roles
• Tuition Reimbursement and Continuing Professional Education
• Paid Time Off – new hires start with at least 20 days of PTO per year in addition to nine company paid holidays.
• As you grow with us, your PTO may increase based on your level within the company and years of service.
• Volunteer days, community partnerships, and Employee Assistance Program
• Ability to connect with colleagues around the country through our Employee Resource Group program

Company Overview