Benefits Coordinator

The Benefits Center Coordinator (BCC) role in Long Term Disability is accountable for managing a block of claims for payment, settlement, and/or triaging depending on area of specialty. 

BCCs have responsibility for understanding the current situation with the claims and activities for which they are responsible. This will be done through file reviews; ongoing claimant contact and the review of medical and financial information to confirm ongoing liability and appropriate benefit payment as outlined in the policy. 
BCCs are responsible for providing effective and efficient claim management practices while demonstrating strong customer service, productivity and documentation skills. 
Fraud identification and prevention is also important for this role, therefore an understanding of the processes related to SIU and Field/Vendor services and appropriate utilization of those resources is expected.

Principal Duties and Responsibilities

• Developing skills to meet departmental standards pertaining to production, quality, timeliness and customer service are met
• Developing skills to accurately identify and management of those files appropriate for further investigation or referral to other areas within the department
• Effectively utilize specialty resources such as medical, vocational and legal to achieve optimum claims outcomes.
• Effectively manage a caseload of claims to the appropriate duration
• Responsible for being familiar with specialized workflow requirements and performance standards for any assigned customers.
• Developing decision rationale and current claim activities accurately and thoroughly; both verbally and in writing, to claimants, employers and other constituents.
• Provides excellent customer service by providing processing benefit payments on a timely basis and responding to all inquiries on a timely basis.
• Maintains accurate and up-to-date activities for each assigned claim, and documents in a thorough, timely and accurate manner.
• Develops and maintains a good rapport with claimants, policyholders and field sales offices.
• Developing an ability to Communicates technical information to claimants, other external customers as appropriate and field personnel regarding financial matters, contractual provisions, benefit calculations and offsets and claim practices.
• Thorough and timely investigation, documentation and analysis of claim decisions.
• Efficient and fair claim management in a high-risk legal environment.
• Render claim related decisions in accordance with policies and procedures, quality and service standards with partnership and direction from management.
• May also manage day to day activities related to Unum’s Retained Asset Account program, including reconciliation of account balances and resolution of discrepancies, resolution of accountholder requests and processing of assignments of life insurance.
• May perform other duties as assigned.

Job Specifications 

• High School Diploma or equivalent, required
• Mathematical aptitude
• Detail oriented; able to analyze and research contract information
• Strong communication, verbal, written, and listening, as well as strong interpersonal skills
• Experience in working with internal and external customers
• Demonstrated critical thinking abilities
• Analytical and decision-making skills
• Ability to deal effectively with conflict in a professional manner
• Ability to negotiate
• Excellent customer service orientation
• Ability and commitment to work as an effective team member toward shared goals.
• Strong organizational and time management skills with an ability to balance production with independent decision-making
• Demonstrated success in meeting goals in demanding and dynamic work environments
• Demonstrated ability to act with sense of urgency and manage multiple demand