Job Posting End Date: November 30 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 in the career path after the Benefits Specialist role within the Absence Management Organization (AMC), and is responsible for handling higher indemnity, more complex claims or larger corporate accounts. The incumbent demonstrates well-developed claim skills, in-depth technical and systems knowledge as well as excellent customer service skills. In addition, the incumbent has demonstrated a higher level of proficiency and independence in all aspects of the claim management and decision-making process and can share their knowledge with lesser experienced employees. Prior to movement to Lead Benefits Specialist incumbents in this position must demonstrate expert skills in claim management, contract interpretation and operation of systems. Additionally, the incumbent demonstrates mentoring and special project work. Principal Duties and Responsibilities Independently manage a full caseload of complex claims, ensuring appropriate sign offs are obtained. This may include responsibility for complex claims/accounts. 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 a thorough knowledge of products, policies/procedures, contracts and medical and vocational issues, financial and legal issues. Demonstrate a strong 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 an 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 strong 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 strong knowledge and effectively utilize a broad spectrum of materials and tools regarding contractual, medical, vocational, disability and RTW strategies, as required. Strong 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. May be responsible for mentoring less experienced employees 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 strong and interpersonal skills Demonstrates strong analytical and problem-solving skills Demonstrates a strong ability to partner effectively with internal and external resources. Exhibits strong negotiation skills and flexibility, as well as a high tolerance for ambiguous situations Demonstrates strong 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 Develops coaching and mentoring abilities. ~IN2 #LI-TS2 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 - 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. $45,600.00-$86,200.00 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 Join our talent community to receive notifications about jobs relevant to your interest. Join our Talent Community! At Unum Group, we’re a Fortune 500 company and leading international provider of workplace benefits and services, helping workers and their families thrive for more than 175 years. Through our Unum and Colonial Life brands, our company offers disability, life, accident, critical illness, dental and vision insurance; leave and absence management support; and behavioral health services. Our 10,000+ employees work across operations in the US, UK and Poland, as well as our dedicated Technology Centre in Ireland. Unum Group is committed to working with and providing reasonable accommodations for any applicant with a disability. If you are disabled and need a reasonable accommodation to participate in the application or hiring process, please contact us by submitting a request here.

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