Ability Specialist Hawaii Team

Ability Specialist - C409BN

We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.

This role requires a Hybrid work arrangement with in office requirement at The Hartford's Hawaii office location.

The Employee Benefits – Ability Specialist for the Hawaii team supports Paid Family and Medical Leave, Short Term Disability and Leave of Absence. This role requires strong analytical expertise, strategic thinking, and communication skills to accurately adjudicate claims. As Ability Specialist for the Hawaii team, you will play a critical role in supporting individuals during some of the most challenging times in their lives.

You will be responsible for managing a caseload of Hawaii TDI, Short Term Disability and Leave of Absence claims of high complexity, ensuring each claim is handled with empathy, accuracy, and efficiency. This role requires a balance of analytical thinking, customer service, and regulatory compliance. You will serve as the primary point of contact for claimants, employers, and medical professionals, guiding them through the claims process and ensuring timely and fair outcomes.

Your work will directly impact the financial and emotional well-being of our customers. This role can be filled as an Ability Specialist or Senior Ability Specialist based on experience.

• Independently manage a caseload of Hawaii state disability, Short Term Disability and Leave of Absence claims from intake through resolution.
• Conduct thorough reviews of medical records, employment history, and policy provisions.
• Determine eligibility and benefit entitlement based on contractual language and supporting documentation.
• Serve as the main contact for claimants, providing clear, compassionate, and timely updates.
• Communicate with employers, physicians, and legal representatives to gather and clarify information.
• Educate claimants on the Hawaii state disability, Short Term Disability and Leave of Absence processes, timelines, and expectations.
• Make well-reasoned decisions supported by evidence and aligned with policy terms.
• Document all claim activity, rationale, and communications in a clear and professional manner.
• Prepare written correspondence including approval, denial, and status letters.
• Collaborate with internal resources such as peers, CRO, SIU, CCXT and Team Leader
• Escalate complex or high-risk claims to senior team members or management as appropriate
• Ensure all claims are handled in compliance with State regulations, HIPAA, and other applicable regulations.
• Participate in audits, quality reviews, and continuous improvement initiatives.

• HS Diploma/GED required;
  Associate's or Bachelor's degree preferred.
• 1+ years of claim experience a plus.
• Medical terminology is a plus.
• Strong organizational and prioritization skills.
• Exceptional problem solving.
• Exceptional Critical Thinking Skills.
• Professional verbal and written communication skills.
• Continuous Improvement Mindset.
• Detail oriented with the ability to maintain a high-level of quality and accuracy, while meeting productivity targets in a fast-paced environment.
• Thrives in a structured team environment.
• Proficiency in Microsoft Office applications and the ability to navigate multiple systems simultaneously.

What Else Can You Tell Me?

• This role can have a Hybrid or Remote work arrangement. Candidates who live near one of our office locations (Hartford, CT, San Antonio, TX, Lake Mary, FL, Sunrise, FL, Scottsdale, AZ, Alpharetta, GA, and Naperville, IL) will have the expectation of working in an office 3 days a week (Tuesday through Thursday). Candidates who do not live near an office will have a remote work arrangement, with the expectation of coming into an office as business need arise.
• For full-time, occasional, part-time or remote positions: (1) high speed broadband internet service is required, we do not recommend or support DSL, wireless, Wi-Fi, Hotspots, Fiber without a modem and Satellite; (2) Internet provider…