Stacey Labbe

Senior Benefits Specialist

Unum Life Insurance

03.2015 - Current

Independently manage a full caseload of complex claims, ensuring appropriate sign offs are obtained.
Independently build action plans, analyze outcomes and render a determination in accordance with our quality and service guidelines.
Independently evaluate and analyze all information in claim files to determine appropriate action steps and adjudication of claims.
Evaluate the need for and ensure timely referrals to others as appropriate.
Work closely with Benefits Research Information team to locate claimants/members and monitor online databases for new information.
Undertake a timely, accurate claims review, initiate appropriate claim validation activities, and recommend either continued approval of benefits or denial of the claim. Can effectively articulate rationale for action.
Display a thorough knowledge policies/procedures, contracts and medical and vocational issues, financial and legal issues.
Apply contract/policy knowledge and analyze technical and complex contractual knowledge (policies and provisions) to ensure appropriate eligibility requirements, liability decisions and appropriate payee.
Produce objective, clear documentation and technical rationale for all claim determinations and demonstrate the ability to effectively verbally communicate determinations.
Demonstrate strong knowledge and effectively utilize a broad spectrum of resources, materials and tools regarding contractual, medical, vocational, disability as required.
Provide timely and excellent customer service by paying appropriate claims promptly and quickly responding to all inquiries.
Maintain expected service and quality standards on all assigned claims.
Protects the Company against extra-contractual liabilities by following established guidelines and regulations.