[Hiring] Senior Life Event Specialist @Unum

Role Description

This position is an advanced level technical position responsible for the thorough, fair, objective, and timely adjudication of the most complex short-term disability claims in conjunction with providing technical expertise regarding FMLA and state leave regulations. This position is responsible for providing excellent customer service and interacts on a regular basis with employees, employers, and health care providers.

Principal Duties and Responsibilities

• Timely and accurate adjudication of complex STD claims
• Processing of leaves associated with an employee’s own health condition
• Apply technical contractual knowledge (policies and provisions) to ensure appropriate eligibility requirements and liability decisions
• Determine complex eligibility and availability of leave for integrated claims/leaves
• Responsible for timely and accurate claims review, initiation and completion of appropriate claim validation activities, and effective communication of rationale for claims action
• Determine and generate appropriate communications to comply with FMLA and State regulations and customer procedures
• Facilitate roundtables when consulted or manager is unavailable
• Provides technical coaching and mentor support to less experienced Benefit Center professionals
• Provides Manager/Director with performance and development feedback for assigned mentees
• Is viewed as a role model, technical expert and leader within the team and Benefits Center
• Provides coverage of daily tasks including customer inquiries and attending customer calls as needed and in times of management absence
• Verify on-going liability and return to work opportunities as appropriate
• Provide excellent customer service by paying appropriate claims promptly and quickly and independently responding to all inquiries within Benefits service guidelines
• Develop relationships with Employer contacts, including HR administrators
• Coordinate file strategies utilizing specialized resources including nurses, physicians, vocational rehabilitation and assessing medical documentation
• Ensure timely referrals/notifications to other areas (i.e., LTD, medical assessments, etc) as appropriate
• Ensure a timely and well communicated transfer process when transitioning integrated claims from STD to LTD, ensuring a coordinated and continuous claims experience to employees
• Maintain organizational service standards on all assigned claims and leaves
• Be familiar with specialized workflow requirements and performance standards for any assigned customers
• May perform other duties as assigned

Qualifications

• 4-year degree preferred or equivalent work experience
• 3 years or more years in the Leave or Disability Benefit Specialist role
• Mastery of all key responsibilities and job specifications of either the Leave or Disability Benefit Specialist roles
• Medical background, Disability claim and/or leave management experience preferred
• Ability to exercise independent judgment and discretion in increasingly complex claim adjudication decisions
• Expectation of increasing levels of skill and ability; ability to manage a wide variety of claims independently
• Demonstrated success in developing and implementing return to work strategies
• Ability to interact effectively and professionally with claimants, employers, medical resources, attorneys, accountants, brokers, sales representatives, etc.
• Strong service and quality orientation
• Possess strong analytical and problem-solving skills
• Meets the standards for this position, as defined in the Talent Management framework

Benefits

• Award-winning culture
• Inclusion and diversity as a priority
• Performance Based Incentive Plans
• Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability
• Generous PTO (including paid time to volunteer!)
• Up to 9.5% 401(k) employer contribution
• Mental health support
• Career advancement opportunities
• Student loan repayment options
• Tuition reimbursement
• Flexible work environments
• *All the benefits listed above are subject to the terms of their individual Plans