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Senior Life Event Specialist

Senior Life Event Specialist

Unum GroupChattanooga, TN, US
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Advanced Technical Position For Short-Term Disability Claims

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, and Baton Rouge, LA - 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.

    The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience. $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.

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    Event Specialist • Chattanooga, TN, US

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