Senior Life Event Specialist

Unum; Oregon; Hybrid; USD 53,000 - 101,000; Full time

Benefits offered by this job

Healthcare benefits

Paid time off including volunteer time

401(k) employer match

Tuition reimbursement

Student loan repayment options

Job summary

Unum is seeking 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 role focuses on delivering excellent customer service while collaborating with employees, employers, and health care providers.

The position requires healthcare/medical background or leave management experience, strong

Qualifications

• 4-year degree preferred or equivalent work experience
• 3+ years in the Leave or Disability Benefit Specialist role
• Mastery of key responsibilities and job specifications of 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
• Strong analytical and problem-solving skills

Responsibilities

• Timely and accurate adjudication of complex STD claims
• Processing of leaves associated with an employee’s own health condition
• Apply technical contractual knowledge to ensure appropriate eligibility 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
• Determine and generate appropriate communications to comply with FMLA and state regulations
• Facilitate roundtables when consulted or manager is unavailable
• Provide technical coaching and mentor support to less experienced Benefit Center professionals
• Provide 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
• Provide coverage of daily tasks including customer inquiries and attending customer calls as needed and in times of management absence
• Verify ongoing liability and return to work opportunities as appropriate
• Provide excellent customer service by paying appropriate claims promptly and quickly
• Develop relationships with Employer contacts, including HR administrators
• Coordinate file strategies utilizing nurses, physicians, vocational rehabilitation and assessing medical documentation
• Ensure timely referrals to other areas as appropriate
• Ensure a timely and well communicated transfer process when transitioning integrated claims from STD to LTD
• 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

Skills

Analytical skills

Problem solving

Customer service

Independent judgment

Communication skills

Education

Bachelor’s degree preferred or equivalent experience

Job description

When you join the team at Unum, you become part of an organization committed to helping you thrive.

Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life’s moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally.

• To enable this, we provide: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

And that’s just the beginning…With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers.

Whether you’re directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team.

Help us help others, and join Team Unum today!General Summary:

General Summary:

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

Job Specifications:

4-year degree preferred or equivalent work experience3 years or more years in the Leave or Disability Benefit Specialist roleMastery of all key responsibilities and job specifications of either the Leave or Disability Benefit Specialist rolesMedical background, Disability claim and/or leave management experience preferredAbility 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 skillsMeets the standards for this position, as defined in the Talent Management framework~IN2#LI-TS2Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland and the UK, Unum also has significant operations in Portland, ME - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide.Unum is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person's race, color, religion, national origin, age, genetic information, military status, gender, sexual orientation, gender identity or expression, disability, or protected veteran status.The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience.$53,300.00-$100,700.00

Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not. All benefits are subject to the terms and conditions of individual Plans.

Company:Unum