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Fmla Claims Examiner Jobs (NOW HIRING)

Oversee a portfolio of complex claims, including those involving co-morbidities, behavioral health ... Qualifications: * 2-3 years of experience in STD is required (FMLA/State Leave experience is ...

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Knowledge of Worker's Compensation and FMLA processes and laws; knowledge of employee benefits ... with Claims Examiners; enters and tracks data related to testing and Worker's Compensation ...

Occupational Health Nurse

Huntington, WV · On-site

$69K - $95K/yr

Conduct new hire pre-employment drug and alcohol screening & coordinate medical examinations ... Advise on Workers' Compensation claims, as needed * FMLA Administration * Maintain HIPPA compliant ...

Occupational Health Nurse

Huntington, WV · On-site

$69K - $95K/yr

Conduct new hire pre-employment drug and alcohol screening & coordinate medical examinations ... Advise on Workers' Compensation claims, as needed * FMLA Administration * Maintain HIPPA compliant ...

Occupational Health Nurse

Huntington, WV · On-site

$69K - $95K/yr

Conduct new hire pre-employment drug and alcohol screening & coordinate medical examinations ... Advise on Workers' Compensation claims, as needed * FMLA Administration * Maintain HIPPA compliant ...

Occupational Health Nurse

New Haven, IN · On-site

$66K - $90K/yr

Conduct new hire pre-employment drug and alcohol screening & coordinate medical examinations ... Advise on Workers' Compensation claims, as needed * FMLA Administration * Maintain HIPPA compliant ...

$85 - $110/hr

Conduct new hire pre-employment drug and alcohol screening & coordinate medical examinations ... Advise on Workers' Compensation claims, as needed * FMLA Administration * Maintain HIPPA compliant ...

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Fmla Claims Examiner information

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$15

$29

$45

How much do fmla claims examiner jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for fmla claims examiner in the United States is $29.40, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $35.10 per hour, depending on experience, location, and employer.

What is an FMLA Claims Examiner?

FMLA Claims Examiners are professionals responsible for reviewing, processing, and managing requests for leave under the Family and Medical Leave Act (FMLA). They evaluate documentation submitted by employees, determine eligibility, ensure compliance with federal and company policies, and communicate decisions to all parties involved. Their role helps ensure that employees receive the protections provided by FMLA while maintaining organizational compliance with legal requirements.

What are the key skills and qualifications needed to thrive as an FMLA Claims Examiner?

To thrive as an FMLA Claims Examiner, you need a solid understanding of federal and state leave laws, attention to detail, and experience in claims processing, often supported by a degree in business, human resources, or a related field. Familiarity with claims management software, HRIS systems, and regulatory compliance platforms is typically required. Exceptional communication, empathy, and problem-solving skills help you effectively interact with employees and employers while managing sensitive cases. These skills are crucial for ensuring legal compliance, accurate claims handling, and a supportive experience for all stakeholders.

What are some common challenges faced by FMLA Claims Examiners when managing leave requests?

FMLA Claims Examiners often encounter challenges such as interpreting complex medical documentation, ensuring compliance with federal and state regulations, and balancing a high volume of cases. Effective communication with employees, healthcare providers, and HR teams is essential to clarify eligibility and resolve discrepancies. Staying organized and up-to-date with evolving legal requirements is key to success in this role, as is maintaining confidentiality and empathy during sensitive situations.

What is the difference between Fmla Claims Examiner vs Disability Claims Specialist?

AspectFmla Claims ExaminerDisability Claims Specialist
CredentialsTypically requires claims processing experience, knowledge of FMLA regulationsRequires claims processing experience, knowledge of disability insurance policies
Work EnvironmentOffice setting, handling FMLA claims for employeesOffice setting, managing disability insurance claims
Industry UsageCommon in HR, insurance, and healthcare sectorsCommon in insurance, healthcare, and employee benefits sectors
Search & Comparison IntentOften compared for roles involving employee leave and benefitsCompared for roles managing disability insurance claims

The Fmla Claims Examiner and Disability Claims Specialist roles share similarities in claims processing and industry settings but differ mainly in their focus areas. The Fmla Claims Examiner specializes in employee leave under FMLA regulations, while the Disability Claims Specialist handles disability insurance claims. Both roles require claims knowledge and office work environments, but their specific regulatory and policy expertise distinguishes them.

How to get a job as a Fmla Claims Examiner?

To become a FMLA Claims Examiner, candidates typically need a high school diploma or equivalent, with some roles preferring a bachelor's degree in a related field such as healthcare, human resources, or insurance. Relevant skills include knowledge of FMLA regulations, claims processing, and strong attention to detail; certifications like the Certified Claims Professional (CCP) can be advantageous. Job opportunities are often found in insurance companies, healthcare organizations, or government agencies, with roles requiring proficiency in claims management software and good communication skills.

Is claims processing a stressful job?

Fmla Claims Examiners are responsible for reviewing and processing family and medical leave claims, which can involve tight deadlines and detailed documentation. The job can be stressful due to the need for accuracy, adherence to regulations, and managing multiple cases simultaneously, especially during high-volume periods. Strong organizational skills and knowledge of relevant laws help manage workload effectively.
More about Fmla Claims Examiner jobs

What cities are hiring for Fmla Claims Examiner jobs?

Cities with the most Fmla Claims Examiner job openings:

What states have the most Fmla Claims Examiner jobs?

States with the most job openings for Fmla Claims Examiner jobs include:

Infographic showing various Fmla Claims Examiner job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 40% In-person, and 60% Remote job distribution, with an average salary of $61,156 per year, or $29.4 per hour.

Senior Disability Claims Examiner (Virtual)

Remote


Prudential

8.7

Company rating: 8.7 out of 10

Based on 49 frontline employees who took The Breakroom Quiz

72nd of 314 rated insurance

People enjoy working here

Good employer

Recommended by students


$61K - $101K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 17 days ago


Job description

Job Classification:

Operations - Insurance Operations

We are seeking a Senior Level Claim Manager to provide top-tier customer service to one of our largest Group Insurance clients. In this role, you will gain a deep understanding of the client's culture and apply your expert customer service skills to guide and support their employees at the start of their leave. You will work with various products, including Short Term Disability, Statutory Leaves, and Absence, to ensure a seamless experience for employees.

As a member of this team, you will go beyond traditional claim management duties. This includes handling customer service calls specifically for your assigned client. You are expected to become thoroughly familiar with the client's culture and product offerings to deliver exceptional service to both the client and their employees. You will look for opportunities to enhance the claimant experience and act as a champion for continuous process improvement within the Concierge Team. You will have the chance to interact with the client's Leave team during quarterly virtual meetings and will engage daily with the client's Benefits Business Partners.

Responsibilities:

  • Provide excellent customer service while managing approximately 95 Short-Term Disability (STD) claims.

  • Oversee a portfolio of complex claims, including those involving co-morbidities, behavioral health issues, and self-reported symptoms.


Qualifications:

  • 2-3 years of experience in STD is required (FMLA/State Leave experience is preferred).

  • Proficient in proactive communication through various channels, such as phone, email, letters, Teams messaging, group Teams calls, and one-on-one video calls, to deliver exceptional service.

  • Energetic and customer-focused, with a proven ability to maintain strong customer relationships.

  • Confident in communicating with highly skilled and educated claimants in the software industry, especially in challenging situations.

  • Excellent documentation skills to accurately capture telephone conversations and create clear, concise claim plans.

  • Ability to understand and interpret complex and non-standard policy and plan provisions.

  • Strong ability to independently navigate ambiguous situations and adapt quickly when needed.

  • Excellent organizational and time management skills.

  • Demonstrated analytical and math skills.

  • Provide technical direction to other claims personnel as needed.

  • Strong teamwork skills and the ability to leverage resources to achieve goals.

Work Environment:

This role is virtual, so candidates must meet the following requirements:

  • Subscribe to an internet service provider plan with at least 25 Mbps download speeds and be willing to troubleshoot any connectivity issues.

  • Capable of handling calls with a cell phone (with unlimited data and minutes) or a landline. Your personal phone number will not be disclosed to customers.

  • Have a quiet, distraction-free work area at home.

  • Preference to be available to work Pacific Time Zone business hours; it not Pacific Time Zone, ability to work a later work shift to support customer located on the West Coast.

  • Demonstrate reliability and dependability throughout the extensive training program.

#LI-MG1

What we offer you:
Prudential is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $61,700.00 to $101,900.00. Specific pricing for the role may vary within the above range based on many factors including geographic location, candidate experience, and skills.
  • Market competitive base salaries, with a yearly bonus potential at every level.
  • Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and leave of absences, such as parental and military leave.
  • 401(k) plan with company match (up to 4%).
  • Company-funded pension plan.
  • Wellness Programs including up to $1,600 a year for reimbursement of items purchased to support personal wellbeing needs.
  • Work/Life Resources to help support topics such as parenting, housing, senior care, finances, pets, legal matters, education, emotional and mental health, and career development.
  • Education Benefit to help finance traditional college enrollment toward obtaining an approved degree and many accredited certificate programs.
  • Employee Stock Purchase Plan: Shares can be purchased at 85% of the lower of two prices (Beginning or End of the purchase period).

Eligibility to participate in a discretionary annual incentive program is subject to the rules governing the program, whereby an award, if any, depends on various factors including, without limitation, individual and organizational performance. To find out more about our Total Rewards package, visit Work Life Balance | Prudential Careers. Some of the above benefits may not apply to part-time employees scheduled to work less than 20 hours per week.


Prudential Financial, Inc. of the United States is not affiliated with Prudential plc. which is headquartered in the United Kingdom.


Prudential is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, ancestry, sex, sexual orientation, gender identity, national origin, genetics, disability, marital status, age, veteran status, domestic partner status, medical condition or any other characteristic protected by law.


If you need an accommodation to complete the application process, please email accommodations.hw@prudential.com.

If you are experiencing a technical issue with your application or an assessment, please email careers.technicalsupport@prudential.com to request assistance.


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