Senior Life Event Specialist

Unum; United States; Remote; USD 53,000 - 101,000; Full time

Benefits offered by this job

Healthcare benefits

Paid time off

401(k) retirement plan with company-mâ

Volunteer time

Job summary

Unum is seeking candidates for an advanced technical role focused on thorough adjudication of complex short-term disability claims and FMLA/state leave expertise. The position emphasizes excellent customer service and collaboration with employees, employers, and health care providers.

Ideal candidates have a 4-year degree (or equivalent), 3+ years in disability/leave roles, and a strong ability to navigate complex policy provisions while delivering timely, accurate outcomes.

Qualifications

• 4-year degree preferred or equivalent work experience.
• 3+ years in the Leave or Disability Benefit Specialist role.
• Mastery of responsibilities and specifications of the Leave or Disability Benefit Specialist roles.
• Medical background or disability/leave management experience preferred.
• Ability to exercise independent judgment in complex claim adjudication.
• Progressive skill growth and independent claim handling.
• Experience developing return-to-work strategies.
• Strong interaction with claimants, employers, medical resources, attorneys, brokers and sales reps.
• High service and quality orientation with analytical problem-solving abilities.
• Compliance with Talent Management standards.

Responsibilities

• Agree timely adjudication of complex STD claims and processing leaves.
• Apply contractual knowledge to determine eligibility and liability.
• Communicate rationale for claims actions clearly and timely.
• Coordinate with nurses, physicians, and vocational resources as needed.
• Ensure timely referrals to LTD and medical assessments.
• Provide coverage for daily tasks and respond to inquiries per guidelines.

Skills

Attention to detail

Customer service

Analytical thinking

Communication

Education

Bachelor’s degree or equivalent

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 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

Unum 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.

$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