PLADS Claims Technical Specialist


Location: Remote - US only

Job Type: Full time


Job Summary

Serves as the claim and/or leave subject matter expert providing support to the Operations leadership team as well as a mentor for case managers.

Principal Duties & Responsibilities

  • Acts as a main point of contact for claims specific questions for the case managers

  • Serves as a mentor for new hires as well as supports new hiring training

  • Takes an active role in refresher training and developing of existing staff

  • Ensures case managers are utilizing appropriate risk management skills to secure the appropriate claim outcome

  • Conducts manager reviews/ audits of claims as necessary to ensure overall quality

  • Provides the appropriate coaching and feedback to case managers as needed

  • Monitors KPIs and reports to ensure service levels and commitments are met, working with case managers as needed

  • Monitors and adjusts workload balancing for case managers

  • Provides support to the manager in facilitating team meetings/ huddles

  • May periodically manage very complex cases directly

  • Elevates any trends and / or coaching opportunities to the leadership team

  • May manage customer escalations

  • Completes special projects and/or ad hoc assignments as requested by the leadership team

  • Performs other related duties as required

Education & Experience Required

  • Minimum Required Bachelor’s Degree In a related field.
  • Minimum Required 5-year minimum STD industry experience
  • Minimum Required 2 years minimum experience working with employees

Or an equivalent combination of education and experience

Job Knowledge & Skills

  • Ability to influence and champion change

  • Excellent critical thinking and decision -making skills

  • Strong leadership and organizational skills

  • Excellent Communication skills (verbal, written & presentation)

  • Strong understanding of contracts, plans and products

  • Strong knowledge of best practices and effective case management skills


  • Acting with Integrity
  • Communicating Effectively
  • Pursuing Self-Development
  • Serving Customers
  • Supporting Change
  • Supporting Organizational Goals
  • Working with Diverse Populations
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