Senior Life Event Specialist

Unum•Portland, ME

13d•$53,300 - $100,700

About The Position

This is an advanced-level technical position responsible for thorough, fair, objective, and timely adjudication of complex short-term disability claims, as well as providing technical expertise on FMLA and state leave regulations. The specialist provides customer service and regularly interacts with employees, employers, and health care providers. The role also serves as a technical expert and leader within the team and Benefits Center, providing coaching and mentoring to less experienced professionals and feedback to managers or directors about assigned mentees. The position involves processing leaves related to employees’ own health conditions, applying policy and contractual knowledge to eligibility and liability decisions, coordinating specialized claim resources, and supporting timely transitions from short-term to long-term disability. The specialist maintains service standards, develops employer relationships, responds to customer inquiries, and may perform other assigned duties.

Requirements

At least 3 years in a Leave or Disability Benefit Specialist role.
Mastery of the key responsibilities and job specifications of either the Leave or Disability Benefit Specialist role.
Ability to exercise independent judgment and discretion in increasingly complex claim adjudication decisions.
Ability to manage a wide variety of claims independently, with increasing levels of skill and ability.
Demonstrated success in developing and implementing return-to-work strategies.
Ability to interact effectively and professionally with claimants, employers, medical resources, attorneys, accountants, brokers, and sales representatives.
Strong service and quality orientation.
Strong analytical and problem-solving skills.
Meet the standards for the position as defined in the Talent Management framework.

Nice To Haves

Four-year degree or equivalent work experience.
Medical background, disability claim experience, and/or leave management experience.

Responsibilities

Adjudicate complex short-term disability claims accurately and promptly.
Process leaves associated with an employee’s own health condition.
Apply contractual and policy knowledge to eligibility requirements and liability decisions.
Determine complex eligibility and leave availability for integrated claims and leaves.
Conduct timely claims reviews, initiate and complete claim validation activities, and communicate the rationale for claim actions.
Generate communications that comply with FMLA and state regulations and customer procedures.
Facilitate roundtables when consulted or when a manager is unavailable.
Coach and mentor less experienced Benefits Center professionals and provide managers or directors with performance and development feedback on assigned mentees.
Serve as a role model, technical expert, and leader within the team and Benefits Center.
Provide coverage for daily tasks, customer inquiries, and customer calls as needed, including during management absences.
Verify ongoing liability and return-to-work opportunities as appropriate.
Pay appropriate claims promptly and respond independently to inquiries within Benefits service guidelines.
Develop relationships with employer contacts, including HR administrators.
Coordinate claim strategies using specialized resources, including nurses, physicians, vocational rehabilitation, and medical documentation assessment.
Make timely referrals and notifications to other areas, such as long-term disability and medical assessments.
Ensure timely, well-communicated transitions of integrated claims from short-term to long-term disability.
Maintain organizational service standards on assigned claims and leaves.
Follow specialized workflow requirements and performance standards for assigned customers.
Perform other duties as assigned.

Benefits

Health, vision, and dental benefits.
Short- and long-term disability insurance benefits.
Performance-based incentive plans.
Paid time off, including paid time to volunteer.
401(k) employer contribution: up to 9.5%, including an employer match up to 5% and an additional 4.5% contribution whether or not the employee contributes.
Mental health support.
Career advancement opportunities.
Student loan repayment options.
Tuition reimbursement.
Flexible work environments.