Human Resources Leave & Claims Specialist

Key Responsibilities

Regulated Leave, Accommodation, and Case Management

• Determine eligibility and coordinate administration of FMLA, PFL, STD, and LTD benefits; manage timelines, recertifications, stacking rules, and required notices.
• Lead ADA accommodation intake and participate in the interactive process, coordinating accommodation options with the Assistant Director of Human Resources and management.
• Maintain compliant case files, correspondence, notices, and regulatory calendars for all assigned cases.
• Produce monthly metrics, KPIs, and audit-ready documentation related to leave, accommodations, and compliance activity.

Workers’ Compensation and Unemployment

• Manage Workers’ Compensation claims from intake through resolution, serving as liaison to insurers and third-party administrators.
• Coordinate work restrictions, return-to-work and light-duty assignments, and applicable OSHA or safety documentation.
• Prepare and submit Unemployment Insurance responses; support hearings and appeals with required documentation and testimony preparation.

Benefits Administration & Billing Reconciliation

• Support day-to-day Benefits Administration in partnership with the Assistant Director of Human Resources, including escalated employee inquiries and issue resolution.
• Assume full responsibility for benefits billing reconciliation, including:
• • Reviewing carrier invoices for accuracy
  • Reconciling enrollments, terminations, and life-event changes
  • Verifying payroll deductions and employer contributions
  • Resolving discrepancies with carriers, brokers, Payroll, and HRIS
• Ensure benefits premium remittances are accurate, timely, and compliant with plan and regulatory requirements.

Qualifications

· Bachelor’s required.

· 3–5+ years in leave administration/WC/UI; healthcare/senior-living experience a plus.

· Expertise in FMLA/PFL/ADA/WC; medical certification review; documentation;

· Advanced proficiency in MS Office (SharePoint, Excel, Outlook, Teams, Word).

· Advanced HRIS proficiency (UKG preferred).

Physical Requirements

· Desk/PC work; occasional walking to units for meetings.

· Ability to handle files up to 15–20 lbs occasionally.

· Reasonable accommodations available.

Non-Physical Requirements

· Confidentiality; empathy with consistency; deadline discipline.

· Clear written and verbal communication with employees, providers, and TPAs.