About this role
The Executive will lead the Insurance L&A team in the SGU_Domain Ops_Domain Ops>IMU_Insurance_Insurance L&A department, ensuring accurate and timely adjudication of disability claims while delivering exceptional service to claimants and third‑party partners. This role requires strong analytical abilities, thorough knowledge of insurance policies, and the ability to collaborate across legal, underwriting, and finance functions to uphold Unum’s claim philosophy and drive operational excellence.
• Conduct thorough, fair, and timely adjudication of assigned disability claims in line with Unum’s philosophy. • Review medical documentation, employment records, and policy terms to determine claim eligibility. • Communicate claim decisions and rationale to claimants, employers, and third‑party providers. • Provide exceptional customer service, addressing inquiries and resolving issues promptly. • Coordinate with internal teams (legal, underwriting, finance) to ensure seamless claim processing. • Maintain accurate claim files and update system records in accordance with compliance standards. • Identify and flag potential fraud or irregularities for further investigation. • Contribute to continuous improvement initiatives and process optimization within the L&A department. • Prepare and present regular reports on claim metrics, trends, and performance indicators. • Mentor junior staff and assist in training on claims adjudication best practices.
• Minimum of 1-year prior customer service experience, Insurance background is a plus • 0 experience – completed 4 years in college maybe considered or 2-year undergrad with BPO experience • High School Diploma required, College level preferred or equivalent work experience • 1 Year of Contact Center Experience with Insurance background is preferred • Preferrable strong knowledge of disability insurance policies and regulatory requirements. • Good analytical and decision‑making skills, written and verbal communication abilities. • Ability to handle sensitive information with confidentiality and integrity. • Customer‑focused mindset with proven problem‑solving aptitude. • Strong attention to detail. • Ability to work collaboratively in a fast‑paced, cross‑functional environment.