Hybrid Leave Management and Claims Specialist bei SummitStone Health Partners

Leave Management and Claims Specialist

• Salary Range: $30.64 - $36.77/hr. based on relevant years of experience
• Location: Larimer county, Colorado
• Status: full time, 40 hours per week
• Hours: Monday - Friday

Role Overview: 

 Responsible for the day-to-day administration of employee leave programs including FMLA, Colorado Paid Family and Medical Leave (CO PFML), and ADA-related accommodations. This position is also the primary contact for Workers’ Compensation claims, ensuring compliance and communication between employees, providers, managers, and the organization’s insurance carrier. The Specialist plays a critical role in ensuring compliance with federal and state laws, internal policies, and timely, supportive employee communications. This role works in close partnership with the People, Culture and Learning (PCL) Manager to coordinate and support more complex Workers’ Compensation cases and ADA accommodations, ensuring consistent, legally compliant, and employee-centered resolution of cases.

Essential Duties:  

• Provide exceptional customer service as the primary point of contact for employees requesting leave. Meet with employees to explain applicable leave options, outline steps in the process, and provide ongoing support from initial requests through return-to-work, ensuring a positive and informed employee experience.
• Administer and track all leave of absence requests, including FMLA and CO PFML. Coordinate with employees, supervisors, and third-party administrators to ensure timely and accurate leave documentation and communication. 
• Serve as the primary point of contact for Workers’ Compensation claims, partnering with departments, employees, providers, and the carrier to ensure proper handling and tracking of claims.
• Partner with the PCL Manager to manage complex ADA accommodation requests and more complicated Workers' Compensation claims that may involve light duty, restriction or long-term resolution planning.
• Maintain accurate records, logs, and correspondence related to all leave and claims activity in accordance with regulatory requirements. 
• Assist in ensuring compliance with all applicable leave-related regulations (FMLA, ADA, HIPAA, CO PFML, etc.).
• Collaborate with the HR team to develop communication materials and training for managers and employees on leave and claims processes.
• Maintain and monitor return-to-work processes, including facilitating return-to-work meetings, ensuring appropriate temporary or ongoing accommodations are in place, issuing job offers for transitional duty, and tracking employee progress to ensure compliance and a smooth reintegration.
• Provide reporting and analytics on leave usage and trends to support proactive workforce planning.
• Coordinate with Payroll Specialist and Benefits Specialist on employee benefit status and benefit premium payments while on leave. Support HR generalists and the Benefits Specialist on cross-functional needs when time allows.
•  Perform other duties as assigned

Required:

• Associate’s degree or two-year college certificate in Human Resources, Business, or related field required; Bachelor’s degree preferred.
• More than three years of experience in administering employee leave of absence programs and/or Workers’ Compensation claims.

• Equivalent combination of education and experience may be evaluated and considered

Highly Desired:

• Professional HR certification (e.g., SHRM-CP, PHR) or specialized training/certification in leave management or related HR compliance areas preferred but not required.
• Bilingual/bi-cultural preferred

Total Rewards

At SummitStone Health Partners we are proud to offer a competitive and competitive benefit package to support the wellbeing of our teams. Visit our website for more information about Total Rewards. 

Reach Out 

SummitStone will provide persons with disabilities with reasonable accommodations. If reasonable accommodation is needed to participate in the job application or selection process, please let your recruiter know.  

Questions?  Please email us at [email protected].  

 This position will be open for a minimum of three days and/or until a top candidate is identified.