Job Description

Job Posting End Date: January 21

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 also has significant US operations in Portland, Maine, - and 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.

General Summary:

In the administration of the Paid Leave (family (PFL) and medical (PML)), Unum assumes responsibility for complying with applicable statutory paid leave laws and similar programs that apply the threshold of serious health condition to medical claims. Although this service may apply to payment and administration, it differs from the adjudication of disability claims in that the standard of review for paid medical leaves does not involve the determination of whether the request involves a disability but rather a serious health condition similar to an FMLA request.

Paid Leave Representatives are responsible for expertise, processing of leaves and claims, review of medical certification, policy provision evaluation and ongoing relationship management with employees requesting leaves and their Employer contacts. The leave representative must exercise independent judgment and critical thinking in decision making.

Principal Duties and Responsibilities:

* Complete processing of new leaves/claims and complete all daily follow-ups assigned.
* Determine eligibility and availability of leave time for each employee requesting leave under statutory paid leave programs and other similar programs
* Processing of leaves associated with an employees own serious health condition under PML programs, utilizing statutory definitions of serious health condition.
* Processing of leaves associated with PFL leave reasons and reviewing medical documentation for decisions and duration review.
* Apply contractual (policies and procedures) and regulatory knowledge to ensure appropriate eligibility requirements and liability decisions.
* Determine and generate appropriate communications to comply with PFL and, where applicable and customer procedures.
* Review medical certifications and other documentation submitted to ensure appropriate sign offs are obtained;
* Communicate medical or absence information with other internal units (STD, Intake).
* Manage leave/claim through duration, develop relationships with Employer contacts, including HR administrators.
* Respond to questions and issues from employees or Employer contacts.
* Maintain organizational service and quality standards on all assigned claims.
* Be familiar with specialized workflow requirements and performance standards for any assigned customers.
* Partnering with financial resources to calculate benefits and BWE.
* Provide excellent customer service by paying appropriate claims promptly and quickly responding to all inquiries.
* May perform other duties as assigned.

Job Specifications:

* 4-year degree or similar experience preferred.
* Ability to exercise critical thinking, 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.
* Strong interpersonal skills and customer relationship skills.
* Strong business communication skills (telephone, e-mail, written).
* Knowledge of Windows; general keyboard and computer skills (Word, Excel, Access).
* Decision making and analytical skills.
* Attention to detail and organizational skills.
* Basic understanding of STD processes, work flows & insurance industry preferred.
* Working knowledge of statutory laws.

Our company is built on helping individuals and families, and this starts with our employees. We want employees to maintain a positive balance, which is why we provide access to the benefits and resources they need to invest in themselves. From our onsite fitness facilities and generous paid time off to employee professional development programs, we are committed to helping employees live and work their best both inside and outside the office.

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