Leave Claims Analyst

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The incumbent is an individual contributor supporting WVU Health System’s employee benefits administration functions. The primary function of this role will be ensuring compliance with Federal, State, local and company leave regulations and policies, and administering pay for leaves of absence accordingly. The incumbent provides guidance on paid leave program policies and procedures to employees and managers and facilitates leave and time off related transactions in the HCM system. Working within a Shared Services environment, the incumbent will address service requests that are escalated to them from the Tier 1 Customer Service team.

MINIMUM QUALIFICATIONS:

EDUCATION AND EXPERIENCE:

1. High school diploma or equivalent and five years of experience in the administration of Absence, Time Off or Leave programs OR

Associate’s degree in human resources, business administration, or related field and three years of experience in administration of Absence, Time Off or Leave programs OR

Bachelor’s degree in human resources, business administration, or related field and one to two years of experience in administration of Absence, Time Off or Leave programs. OR

Master’s degree in human resources, business administration, or related field

PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. SHRM or HRCI certification

EXPERIENCE:

1. 3+ years of experience in the administration of Leave of Absence programs including Time Off, Short-Term Disability, and FMLA.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position.  They are not intended to be constructed as an all-inclusive list of all responsibilities and duties.  Other duties may be assigned.

1. Analyzes routine and complex leave requests in accordance with company policy and applicable laws and facilitates an effective leave management program

2. Responsible for Handles daily administration of the company’s leave of absence program.  Processes leave payments to employees on pending and active leaves in compliance with all leave policies.

3. Facilitates coordination of absences from the inception to the resolution of the leave including: sending all appropriate notifications in a timely manner, making determination and sending notifications, entering notes, managing and completing task list tasks in a timely manner, properly attaching documents to a case, properly executing timely return to work notifications, and intermittent leaves for associates across multiple locations and states.

4. Manages the direct billing of company benefits of associates on unpaid leaves.

5. Conducts regular audits of the leave process to ensure adherence to policies, guidelines and regulations.

6. Monitors status of all leaves of absences and takes proactive measures to ensure all necessary updates and communications are provided to employees and leave process is efficient.

7. Maintains data and document records to ensure compliance and accountability.

8. Act as a subject matter expert in the areas of absence management programs, answering employee inquiries as it relates to paid and unpaid leave programs

9. Provide guidance on paid leave program policies and procedures to employees and managers; liaise with team members to coordinate communication and resolve customer issues

10. Track, investigate, update, and close cases within the case management tool; answer phone calls and respond to emails within established service-level agreement timelines

11. Maintain a broad knowledge of company policies; apply documented procedures, policies and other reference materials to accurately resolve employee inquiries, utilizing sound judgment

12. Liaise and maintain appropriate relationships with internal Shared Services and HRIS teams, and facility level HR Business Partners

13. Stays current on laws, case law, regulations and legal precedents relating to leaves. In partnership with legal, ensures company leave-related policies and guidelines follow local, state and federal regulations.

14. Accurately update data in the HCM software, escalating issues requiring troubleshooting to senior staff and/or HRIS as applicable. 

15. Strong knowledge of FMLA, LOA and ADA regulations.

16. Advanced working knowledge of Microsoft applications; specifically, Word and Excel

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Sitting and standing for long periods of time

2. Working on a computer

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Normal Office environment

SKILLS AND ABILITIES:

1. Strong verbal/written communication skills necessary to interact diplomatically and tactfully with diverse groups of people; effective interpersonal skills; strong attention to detail

2. Ability to build relationships with other HR teams and with customers to effectively deliver absence and time off programs.

3. Familiarity with HR policies and procedures as well as audit functions and procedures

4. Leave Management Software/Case Management Software experience preferred.

5. Effective problem solving and troubleshooting skills. 

6. Highly organized with strong follow up skills and the ability to multi-task.

7. Proficiency with MS Office, Ultimate Ulti-Pro HCM, Kronos Time & Attendance and other computer applications as required.  Ability to utilize search tools and knowledgebase tools to find relevant information

8. Ability to consider multiple variables to determine proper course of action

9. Exercise good judgment in handling sensitive and confidential information and situations.

10. Ability to execute in a fast paced, high demand, environment while balancing multiple priorities

11. Ability to quickly establish credibility to build and maintain effective working relationships

12. Ability to maintain confidentiality and appropriately handle sensitive information with tact and discretion

Additional Job Description:

Scheduled Weekly Hours:

40

Shift:

Exempt/Non-Exempt:

United States of America (Exempt)

Company:

SYSTEM West Virginia University Health System

Cost Center:

554 SYSTEM HR Shared Services