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Eligibility Specialist
Eligibility Specialist-May 2024
Portland
May 13, 2025
About Eligibility Specialist

  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:

  Minimum starting base pay is $46,000

  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

  *Existing remote employees are eligible to apply.

  #LI-KD1

  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, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide.

  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.

  $36,000.00-$64,800.00

  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

  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.

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