Integrated Absence Specialist Tristar Insurance Tristar Insurance 4 reviews

In Signal Hill, Ca office or Possibly remote

POSITION SUMMARY: Sets up and administers Leave of Absence, Voluntary Disability, Paid Family Leave, Short Term Disability and Long Term Disability Claims in accordance with TRISTAR ICS protocols and Employer specific service requirements.



This position varies in responsibility starting with a Level I to a level IV, and may perform some or all of the duties in a more independent manner relative to their level, as listed below:

  • Manages, tracks, and determine eligibility for all aspects of job protected leaves including federal, statutory, employer sponsored leaves (i.e. FMLA, CFRA, PDL, PLOA)
  • Incumbent is expected to administer a case load that meets industry standards of best practices (current range is up to 150 claims, eff. 2/2017)
  • Acts as a resource to clients and staff regarding the requirements and regulations of the above mentioned leaves with company benefits and internal leave policies
  • Follow established procedures and policies to administer disability/PFL claims in a timely and efficient manner.
  • Update leave/claim files and notes in the computer as appropriate.
  • Coordinate coverage and administration of insured programs with the appropriate carrier.
  • Review mail/email daily.
  • Establishes and maintains rapport with clients and their employees to ensure customer service goals are met.
  • Maintain and administer appropriate check cycle payments and procedures.
  • Reconcile overpayment/underpayment occurrence, which includes making payment arrangements, sending letters and maintaining of overpayment/underpayment recap.
  • Coordinate return to work efforts with claimant, provider, and client
  • Answer all telephone claim calls from claimants, clients and carriers within 24 hours.
  • Provide highest quality of customer service.
  • Follow attendance policy: consistency in work schedule and punctuality.
  • All other duties as assigned.

Education/Experience: High school diploma or GED (minimum). One (1) year experience in administrative office environment for a Level I to 3-5 years leave management background for a Level IV.

Knowledge, Skills and Abilities:

  • Must be organized and possess the ability to document files accurately.
  • Must have a general understanding of Federal and Statutory regulations regarding FMLA, CFRA, and PDL.
  • The ability to comprehend and integrate the above programs with VDI, STD, and VDI benefits.
  • Computer proficient in Word, Excel, and Web applications.
  • Ability to effectively communicate, both verbally and in writing with employees, supervisors, and external providers using tact and diplomacy when expanding decisions.
  • Ability to educate and counsel on sensitive and complex issues.
  • Good planning and organization skills to multitask in a high volume and fast paced work environment.
  • Ability to solve practical problems and to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
  • Ability to understand Disability Plan Documents, SOC and ERISA Guidelines.

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