About the position
As a Benefits Specialist Trainee at Unum, you will embark on an entry-level journey within the Absence Management Center (AMC). This role is designed for individuals who are eager to learn and develop the necessary skills, knowledge, and behaviors to effectively adjudicate a high volume of assigned claims. You will be paired with a formal mentor for a period of 6 to 12 months, during which you will gain hands-on experience and guidance until you are assessed as capable of independent work. Your primary responsibility will be to manage an assigned caseload, ensuring that you adhere to Unum's claims philosophy, policies, and procedures. This position requires you to demonstrate discretion and independent judgment while rendering timely claim decisions, all while providing exceptional customer service. In this role, you will develop the skills needed to manage a large volume of claims, ensuring that appropriate sign-offs are obtained. You will gain a comprehensive understanding of Unum's products, policies, procedures, and contracts, as well as the relevant definitions, provisions, clauses, exclusions, riders, and waivers. You will also learn about the regulatory and statutory requirements for the claim products administered by Unum. Your analytical and logical thinking skills will be put to the test as you develop problem-solving abilities, recognizing multiple connections and optimizing results to make fair and objective claim decisions. Additionally, you will be responsible for verifying ongoing liability and developing strategies for return-to-work opportunities as appropriate. You will produce clear documentation and technical rationale for all claim determinations and will be expected to communicate these determinations effectively, both verbally and in writing. You will also coordinate and share information with other products as necessary, ensuring that you provide timely and excellent customer service by processing claims promptly and responding to inquiries efficiently. Maintaining expected service and quality standards on all assigned claims is crucial, as is protecting the company against extra-contractual liabilities by following established guidelines and regulations. Other duties may be assigned as needed.
Responsibilities
- Develop skills to manage a large volume of claims, ensuring appropriate sign-offs are obtained.
- Gain an understanding of Unum products, policies, procedures, and contracts.
- Learn applicable contract/policy definitions and relevant provisions, clauses, exclusions, riders, and waivers.
- Apply contract/policy knowledge to ensure appropriate eligibility requirements and liability decisions.
- Develop problem-solving skills to make fair and objective claim decisions.
- Verify ongoing liability and develop strategies for return-to-work opportunities.
- Produce clear documentation and technical rationale for all claim determinations.
- Effectively communicate determinations verbally and in writing.
- Utilize a broad spectrum of materials and tools regarding contractual, medical, vocational, disability, and RTW strategies.
- Develop operating knowledge of the applicable claims systems.
- Coordinate and share information with other products as appropriate.
- Provide timely and excellent customer service by processing claims promptly and responding to inquiries.
- Maintain expected service and quality standards on all assigned claims.
- Protect the company against extra-contractual liabilities by following established guidelines and regulations.
Requirements
- High School Diploma or equivalent required.
- Customer service or decision-making experience and/or college experience.
- Ability to utilize claim evaluation techniques to identify and evaluate claim information in a timely, fair, and objective manner.
- Detail-oriented with the ability to analyze and research contract information.
- Ability to maintain confidence in making fair and appropriate decisions even in disagreement.
- Demonstrated ability to operate with urgency and make balanced decisions with integrity and fairness.
- Ability to influence others to reach constructive conclusions.
- Essential PC skills; ability to operate effectively in an imaged environment.
- Demonstrated ability to multitask and balance goals and priorities in a high-volume environment.
- Self-motivated and independent with proven ability to work effectively in a collaborative team environment.
- Excellent customer service skills.
- Strong communication skills, including verbal, written, and listening, as well as strong interpersonal skills.
- Possess analytical and problem-solving skills.
Nice-to-haves
- Experience in a high-volume claims environment.
- Familiarity with employee benefits and insurance products.
Benefits
- 401(k) with 5% match
- Dental insurance
- Disability insurance
- Health insurance
- Loan repayment program
- Opportunities for advancement
- Generous PTO including paid time to volunteer
- Mental health support
- Career advancement opportunities
- Tuition reimbursement
- Flexible work environments
