Sr. Life Event Specialist

UNUM Group•Chattanooga, TN

44d

About The Position

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.

Requirements

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

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

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