STD Lead Benefit Specialist

When you join the team at Unum, you become part of an organization committed to helping you thrive.

Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life’s moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide:

• 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

*All the benefits listed above are subject to the terms of their individual Plans .

And that’s just the beginning…

With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers. Whether you’re directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. Help us help others, and join Team Unum today!

General Summary:

This position is the next step after the Senior Benefits Specialist role and is an advanced level technical position in the career path for Benefits Specialists in the Absence Management Center (AMC) and is responsible for handling the most complex claims and/or larger/sensitive corporate accounts.

The incumbent demonstrates very well-developed claim skills, the ability to work independently, in-depth contract knowledge and familiarity with system(s) as well as excellent customer service skills. The incumbent demonstrates a high level of proficiency and independence in every aspect of their role and is expected to share their knowledge with lesser experienced employees.

Principal Duties and Responsibilities

• Manage a full caseload of the most complex claims/accounts, ensuring appropriate sign offs are obtained. Caseload size may vary by product(s).
• Independently build action plans, analyze outcomes and render a determination in accordance with our quality and service guidelines.
• Independently evaluate and analyze all information in claim files to determine appropriate action steps and adjudication of claims.
• Evaluate the need for and ensure timely referrals to others as appropriate.
• Undertake a timely, accurate claims review, initiate appropriate claim validation activities, and recommend either initial approval of benefits or denial of the claim. Can effectively articulate rationale for action.
• Display an expert knowledge of products, policies and contracts and medical and vocational issues, financial and legal issues and claim department policies/procedures.
• Demonstrate an expert understanding of the applicable contract/policy definitions and relevant provisions, clauses, exclusions, riders and waivers as well as regulatory and statutory requirements for claim products administered.
• Apply contract/policy knowledge and analyze technical contractual knowledge (policies and provisions) to ensure appropriate eligibility requirements, liability decisions and appropriate payee.
• Problem solve with a strong independent demonstration of analytical/ logical thinking, recognizing multiple connections, optimizing results by choosing the best strategies resulting in fair and impartial claim decisions
• Verify on-going liability and develop strategies for return to work opportunities as appropriate. Demonstrate expert claim validation and return to work techniques, where applicable.
• Produce objective, clear documentation and technical rationale for all claim determinations and demonstrate the ability to effectively verbally communicate determinations.
• Demonstrate expert knowledge and effectively utilize a broad spectrum of materials and tools regarding contractual, medical, vocational, disability and RTW strategies, as required.
• Expert operating knowledge of the applicable claims system(s).
• Coordinate and share information with other products as appropriate.
• Provide timely and excellent customer service by paying appropriate claims promptly and quickly responding to all inquiries.
• Maintain organizational service and quality standards on all assigned claims.
• This position may be responsible for multiple lines of business as part of our integrated service model.
• Protects the Company against extra-contractual liabilities by following established guidelines and regulations.
• Provides mentoring support to less experience employees.
• Acts as and is viewed as a role model.
• May perform other duties as assigned.

Job Specifications

• Mastery of all key responsibilities and job specifications of subordinate positions
• Excellent customer service skills.
• Excellent communication, verbal, written, and listening as well as excellent interpersonal skills
• Demonstrates excellent analytical and problem-solving skills
• Demonstrates an expert ability to partner effectively with internal and external resources.
• Exhibits expert negotiation skills and flexibility, as well as a high tolerance for ambiguous situations
• Demonstrates advanced knowledge of policies and contracts; medical terminology, related legislation, claim validation and early intervention techniques, return to work assistance and departmental practices and procedures, as appropriate
• Demonstrates strong coaching and mentoring abilities
• Takes on additional leadership opportunities within the organization

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.

Company:

Unum