Unum is a company of people serving people. As one of the world’s leading employee benefits providers and a Fortune 500 company, Unum’s financial protection benefits help protect more than 36 million working people and their families from the financial impact of illness or injury. Unum’s three distinct, but similarly focused US businesses – Unum US, Colonial Life, and Starmount Life – are each a market leader in making disability, life, accident, critical illness, dental, and vision insurance accessible in the workplace.
Headquartered in Chattanooga, Tennessee, Unum has significant US operations in Portland, Maine, Worcester, Massachusetts, and Glendale, California with over 35 field offices nationwide. Colonial Life is headquartered in Columbia, South Carolina with over 40 field offices nationwide. Starmount Life is based in Baton Rouge, Louisiana, and is the dental and vision center of excellence for Unum in the US.
This position is responsible for the thorough, fair, objective, and timely adjudication of short-term disability claims in conjunction with providing technical expertise regarding FMLA and specialized state leave regulations. This position is responsible for providing excellent customer service and interacts on a regular basis with employees, employers, health care providers and other specialized internal resources. This role also requires a high level of mentoring and support from manager as part of the developmental plan.
This position will start in March.
Principal Duties and Responsibilities:
- Timely and accurate adjudication of STD claims initially with development to more complexity as experience is gained
- Processing of leaves associated with an employee’s own health condition
- Develop and apply technical contractual knowledge (policies and provisions) to ensure appropriate eligibility requirements and liability decisions
- Develop skill set to 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
- Provide excellent customer service by paying appropriate claims promptly and quickly and independently responding to all inquiries within service guidelines
- Develop relationships with Employer contacts, including HR administrators
- Partner and coordinate file strategies utilizing specialized resources including nurses, physicians, vocational rehabilitation and assessing medical documentation
- 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
- Ability to develop Leave and STD product knowledge and apply a best in class service experience
- Medical background, Disability claim and/or leave management experience preferred
- Ability to exercise independent judgment and discretion in antepartum and postpartum claim adjudication decisions.
- Ability to interact effectively and professionally with claimants, employers, medical resources, attorneys, accountants, brokers, sales representatives, etc.
- Strong service and quality orientation.
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Unum and its family of businesses offer world-class training and development, generous compensation and benefits packages, and a culture built on employee ideas.
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.
Company:
Unum