Senior Life Event Specialist

Unum Group•Chattanooga, TN

11d

About The Position

This advanced-level technical position adjudicates complex short-term disability (STD) claims thoroughly, fairly, objectively, and promptly, while providing technical expertise on FMLA and state leave regulations. The specialist interacts regularly with employees, employers, and health care providers and is responsible for excellent customer service. The role also serves as a technical expert and team leader, coaching and mentoring less experienced Benefits Center professionals and supporting managers with feedback on mentees’ performance and development.

Requirements

At least 3 years of experience 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 and independently manage a wide variety of claims.
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, including claims associated with an employee’s own health condition.
Apply policy and contractual knowledge to assess eligibility and liability, including complex eligibility and leave availability for integrated claims and leaves.
Review claims, initiate and complete validation activities, and communicate the rationale for claim decisions effectively.
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 for assigned mentees.
Serve as a role model, technical expert, and leader within the team and Benefits Center.
Provide coverage for daily tasks, respond to customer inquiries, and attend customer calls as needed, including during management absences.
Verify ongoing liability and assess return-to-work opportunities as appropriate.
Deliver excellent customer service by paying appropriate claims promptly and independently responding to inquiries within Benefits service guidelines.
Develop return-to-work strategies and relationships with employer contacts, including HR administrators.
Coordinate claim-file strategies using specialized resources, including nurses, physicians, vocational rehabilitation, and medical documentation assessments.
Make timely referrals and notifications to other areas, such as long-term disability and medical assessments.
Ensure timely, well-communicated transfers of integrated claims from STD to LTD to support a coordinated and continuous employee experience.
Maintain organizational service standards for assigned claims and leaves and follow specialized workflow requirements and performance standards for assigned customers.
Perform other duties as assigned.