MGB Senior Integrated Paid Leave Specialist

Unum Group•Chattanooga, TN

48d

About The Position

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: In the administration of the FMLA and Paid Family and Medical Leave (PFML), Unum acts on behalf of the employer and assumes full responsibility for complying with the FMLA and applicable state leave laws along with similar employer specific programs that apply the serious health condition threshold to STD like plans. This service is a hybrid of adjudication of an insurance claim and leave administration and may also apply to payment and administration of corporate paid leave policies including parental, caregiver, military and medical leaves. This position plays a key role in the ongoing relationship management with employees requesting leaves and their Employer or field contacts. They also serve as a mentor to newer employees. They must also demonstrate a partnership with other business areas (Benefits Center, Financial, Legal, Contact Center, etc.). Unum is subject to fines and penalties levied by the Department of Labor or by the state as well as legal expenses incurred by the employer. Senior Paid Leave Specialists are responsible for technical expertise (FMLA,225+ state regulations), complex processing of leaves/claims, review of medical certification, and ongoing relationship management with employees requesting leaves and their Employer contacts. The representative must exercise a high level of independent judgment and critical thinking in decision making, and be fully versed on the FMLA, applicable state leave laws as well customer specific processing requirements.

Requirements

Mastery of the key accountabilities of the Integrated Paid Leave Specialist position.
Consistently demonstrates high level of professionalism and excellent performance.
4-year degree or similar 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.
Strong interpersonal skills and customer relationship skills.
Strong business communication skills (telephone, e-mail, written).
Knowledge of Windows; general keyboard and computer skills (Word, Excel, Access).
Decision making and analytical skills.
Attention to detail and organizational skills.
Basic understanding of STD processes and work flows and insurance industry preferred.
Working knowledge of statutory laws

Responsibilities

Manages a caseload of new leaves and claims.
Active working knowledge of varying statutory benefit regulations—i.e. eligibility, entitlement, benefit calculations—and ability to continue building expertise for upcoming new statutory state plans.
Integrated files: ability to accurately navigate and execute adjudication within files comprised of a combination of leave protections—i.e. statutory benefits, FMLA, corporate leaves, state-specific EE offsets.
Processing of leaves associated with an employee’s own serious health condition under PML programs, utilizing statutory definitions of serious health condition.
Apply contractual and regulatory knowledge to ensure appropriate eligibility requirements and liability decisions.
Meet & maintain accuracy and quality expectations regarding integrated files that require a specialist to work out of both claim & leave.
Facilitates new paid leave customer implementation education for teams and has ability to discuss and educate on industry trends for paid leaves.
Assist with the development of new statutory paid leave products and participate in shaping Unum’s paid leave offering.
Develop relationships with Employer contacts, including HR administrators.
Provide excellent customer service by paying appropriate claims promptly and quickly and independently responding to all inquiries.
Determine and generate appropriate communications to comply with PFML and, where applicable, FMLA and State regulations and customer procedures.
Manage leave/claim through duration, develop relationships with Employer contacts, including HR administrators.
Serve as mentor and coach to new and existing Integrated Paid Leave Specialist on workflows, processes, decision making, and complex service issues.
Contributes as a subject matter expert in business and systems (Navilink, BAS, Finance Hub).
Ability to represent the IPLS team on special projects as needed.
Calculates benefits, BWE and offsets.
Provide mentoring and coaching to team members on complex financial situations.
Presents paid leave offerings to prospective/current customers.
Stays up to date on the evolving paid leave statutory landscape.
Review medical certifications and other documentation submitted; consult with Nurse Case Manager if needed.
Provides director/manager with performance/feedback for assigned mentees.
Provide backup support for manager: reviewing & assisting with file escalations, spot-audits, specialist feedback and attending customer calls as needed.
Maintain organizational service standards on all assigned claims.
May perform other duties as assigned.

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