Job Posting End Date : June 20

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 :

In the administration of the FMLA and Paid Family and Medical Leave (PFML), Unum acts on behalf of the employer and assumes full responsibility for complying with the FMLA and applicable state leave laws along with similar employer specific programs that apply the serious health condition threshold to STD like plans This service is a hybrid of adjudication of an insurance claim and leaves request administration and may also apply to payment and administration of corporate paid leave policies including parental, caregiver, military and medical leaves.

Paid Leave Representatives are responsible for technical expertise (FMLA,225 state regulations), complex processing of leaves / claims, review of medical certification, and ongoing relationship management with employees requesting leaves and their Employer contacts.

The representative must exercise a high level of independent judgment and critical thinking in decision making, and be fully versed on the FMLA, applicable state leave laws as well customer specific processing requirements.

Partnering with other business areas (Benefits Center, Contact Center, etc.) is also important to the success of the leave management operation.

Principal Duties and Responsibilities :

• Complete processing of new leaves and complete all daily follow-ups assigned.
• Determine eligibility and availability of leave time for each employee requesting leave for PFML, corporate-paid ER plans, and other statutory benefits.
• Active working knowledge of varying statutory benefit regulations i.e. eligibility, entitlement, benefit calculations and ability to continue building expertise for upcoming new statutory state plans.
• Integrated files : ability to accurately navigate and execute wholistic adjudication within files comprised of a combination of leave protections i.

e. statutory benefits, FMLA, corporate leaves, state-specific EE offsets.

• Processing of leaves associated with an employee’s own serious health condition under PML programs, utilizing statutory definitions of serious health condition.
• Apply contractual and regulatory knowledge to ensure appropriate eligibility requirements and liability decisions.
• Meet & maintain accuracy and quality expectations regarding integrated files that require a specialist to work out of both claim & leave.
• Stays up to date on the evolving paid leave statutory landscape.
• Determine and generate appropriate communications to comply with PFML and, where applicable, FMLA and State regulations and customer procedures.
• Review medical certifications and other documentation submitted; consult with Nurse Case Manager if needed.
• 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.
• Calculates benefits, BWE and offsets.
• Ability to discuss and educate on industry trends for corporate paid leaves.
• 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, relevant experience preferred.
• Knowledge of FMLA regulations and internal FMLA processes.
• Working knowledge of state paid and unpaid leave laws.
• 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).
• Strong decision making and analytical skills.
• Demonstrates strong attention to detail and high organizational skills.
• Basic understanding of STD processes and workflows and insurance industry preferred.

LI-CC1

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.

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.

$40,000.00-$72,000.00

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

Unum

Last updated : 2024-04-29