Eligibility Specialist

Full Time
United States Minor Outlying Islands
Posted
Job description
Job Posting End Date: January 02

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 two distinct, but similarly focused US businesses – Unum US and Colonial 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 Baton Rouge, Louisiana - and over 35 field offices nationwide. Colonial Life is headquartered in Columbia, South Carolina with over 40 field offices nationwide.

General Summary:
What Makes Unum Unique?

We want you to have more than a job; we want you to have a career where you can grow by developing and harnessing your strengths. As a benefits company, we help other companies care for their employees by providing a financial safety net. As a market leader, we lead by example by ensuring our employees know they are valued and giving them the best opportunity to succeed professionally and personally. Here’s how we do that:




Award winning culture

Prioritizing inclusion and diversity

Stellar benefits

Generous PTO (including paid time to volunteer!)

Up to 9.5% company contribution to 401K

Mental health support

Career advancement opportunities

Student loan repayment options

Tuition reimbursement




And that is just the beginning…

Every role at Unum is meaningful. With the help of our 10,000 employees, we protect over 39 million people worldwide during life's ups and downs. Whether claimants are expecting a new family member or going through a tough loss, we are here to support them and make the process as easy as possible. Help us help others and join our incredible team today!

Job Profile Summary
Eligibility Specialist is responsible for technical expertise (FMLA and 100+ state regulations), the determination of eligibility for leaves and short-term disability claims and initial Navilink set up for each. This position is accountable for the accurate and efficient intake of new claims. The representative must exercise independent judgment and be fully versed on FMLA and applicable state leave laws as well customer specific processing requirements. Associates in this role will be interacting with claimants/employers and partnering with other business areas (Benefits Center, Contact Center, etc.); therefore, strong customer service / communication orientation is a core competency while demonstrating the ability to operate across various systems and product workflows

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 FMLA, State, and applicable Corporate protections
  • Determine and generate appropriate communications to comply with FMLA and State regulations and customer procedures
  • Independently determine appropriate status of leave under FMLA and state leave regulations taking into consideration regulatory requirements, company-specific requirements.
  • Determine and provide initial Short-Term Disability eligibility evaluation
  • Systematic initiation of new claims in support of various Unum product types utilizing the appropriate claim adjudication system.
  • Perform a policy coverage search to determine claim filing eligibility and process/triage based on standard and/or customized policy instructions.
  • Manage pending/incomplete prior to triage/assignment to the corresponding claims organization/team.
  • Contribute to individual quality/production expectations to ensure the achievement of organizational turnaround time expectations.
  • Promote a positive customer service experience through prompt, accurate and courteous responses to internal and external customers’ expectations.
  • Continue to build additional knowledge and understanding of the Unum business
  • Participate in training/development of new staff.
  • Identify trends, issues and innovative ideas and partner in solutions.
  • Identify and capitalize on best practices to ensure consistency and optimal performance in a team based environment.
  • Identify and share process improvements to enhance customer service.
  • Demonstrate leadership by promoting a positive team environment which results in motivated and empowered peers.
  • Support various project work as needed.
  • May perform other duties as needed.

Job Specifications

  • High school diploma or equivalent required. 4-year degree or similar experience preferred
  • Schedule for this role is 8-5EST, Monday – Friday. Although these will be the core hours, overtime may be requested/required outside of those hours.
  • Understanding of STD processes and work flows and insurance industry preferred
  • Demonstrate research and problem-solving skills
  • Ability to multi-task, with a demonstrated ability to work in a fast-paced environment handling a large volume of work
  • Action oriented, results driven and a team player that includes working with team members in a cross-site work environment
  • Possess an innovative mindset and is adaptable to change; ability to deal with multiple, concurrent and rapidly changing demands
  • Seeks out job challenges and opportunities to constantly improve skills
  • 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
  • Strong work ethic with consistent job attendance history

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

In accordance with Colorado’s Equal Pay For Equal Work Act, if you are a resident of the state of Colorado and wish to review the salary information for a role posted in Colorado, please fill out the form below and our Unum HR representative will reply to your inquiry within three business days.

Colorado’s Equal Pay For Equal Work Act

In accordance with New York City Human Rights Law, if you wish to review the salary information for a role posted in New York City, please fill out this form and our Unum HR representative will reply to your inquiry within three business days.

New York City Human Rights Law

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