Integrated Paid Leave Specialist- Hybrid

6 days ago

Portland, United States Unum Full time

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

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**: Position start date is July 8, 2024

**This position is located at our Portland, Maine or Chattanooga, TN home office location**

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.
- 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.
- 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.

~IN2
LI-CC1
hybrid

Unum and Colonial Li

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