Claims Technical Lead

AFLAC, INCORPORATED.; Farmington (CT); On-site; USD 75,000 - 95,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision coverage

Flexible spending accounts

401(k) plan

Annual bonus

Stock purchase plan

Paid holidays

PTO

Job summary

AFLAC, INCORPORATED. is seeking a remote Claims Manager to support STD/LTD, life, and absence management from home within the continental US. You will be the main point of contact for claims questions, mentor staff, and drive high-quality outcomes with strong risk management.

The role requires a Bachelor's degree and 4+ years of related experience, with solid leadership, communication, and organizational skills. Competitive compensation and extensive benefits are offered.

Qualifications

• Bachelor's degree in Health Administration, Business, or related field.
• 4+ years job-related experience.
• 2 years case management experience in STD/LTD, Life, Absence Management, or related field. Equivalent education/experience accepted.

Responsibilities

• Acts as a main point of contact for claims questions for the case managers.
• Mentors new hires and supports training.
• Conducts refresher training and development of existing staff.
• Ensures case managers use risk management skills to secure claim outcomes.
• Performs manager reviews/audits to ensure quality.
• Provides coaching and feedback to case managers as needed.
• Monitors KPIs and reports to ensure service levels.
• Assists in workload balancing for case managers.
• Supports management in team meetings/huddles.
• May manage complex cases and escalations.
• Elevates trends and coaching opportunities to leadership.
• Completes special projects and ad hoc assignments.

Skills

Influence and change champion

Critical thinking

Leadership and organization

Communication skills

Contracts and products knowledge

Case management knowledge

Education

Bachelor's degree in Health Administration or related field

4+ years related experience

2 years in case management (STD/LTD or related)

Job description

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We are the duck. We develop and empower our people, cultivate relationships, give back to our community, and celebrate every success along the way. We do it all…The Aflac Way.

Aflac, a Fortune 500 company, is an industry leader in voluntary insurance products that pay cash directly to policyholders and one of America's best-known brands. Aflac has been recognized as Fortune’s 50 Best Workplaces for Diversity and as one of World’s Most Ethical Companies by Ethisphere.com.

Our business is about being there for people in need. So, ask yourself, are you the duck? If so, there’s a home, and a flourishing career for you at Aflac.

Worker Designation

This role is a remote role. This means you will be expected to work from your home, within the continental US. If the role is remote, there may be occasions that you are requested to come to the office based on business need. Any requests to come to the office would be communicated with you in advance.

What does it take to be successful at Aflac?

• Acting with Integrity
• Communicating Effectively
• Pursuing Self-Development
• Serving Customers
• Supporting Change
• Supporting Organizational Goals
• Working with Diverse Populations

What does it take to be successful in this role?

• Ability to influence and champion change.
• Excellent critical thinking and decision -making skills.
• Strong leadership and organizational skills.
• Excellent Communication skills (verbal, written & presentation).
• Strong understanding of contracts, plans and products.
• Strong knowledge of best practices and effective case management skills.

Education & Experience Required

• Bachelor's Degree In Health Administration, Business, a related field.
• 4 or more years job-related experience.
• 2 years case management experience in STD/LTD, Life, Absence Management, or a related field/industry.

Or an equivalent combination of education and experience

• Acts as a main point of contact for claims specific questions for the case managers.
• Serves as a mentor for new hires as well as supports new hiring training.
• Takes an active role in refresher training and development of existing staff.
• Ensures case managers are utilizing appropriate risk management skills to secure the appropriate claim outcome.
• Conducts manager reviews/audits of claims as necessary to ensure overall quality.
• Provides the appropriate coaching and feedback to case managers as needed.
• Monitors KPIs and reports to ensure service levels and commitments are met, working with case managers as needed.
• Monitors and adjusts workload balancing for case managers.
• Provides support to management in facilitating team meetings/ huddles.
• May periodically manage complex cases and customer escalations.
• Elevates any trends and/or coaching opportunities to the leadership team.
• Completes special projects and/or ad hoc assignments as requested by leadership.
• Performs other related duties as required.

Total Rewards

The salary range for this job is $75,000 - $95,000. This range is specific to the job and salary offers consider a wide range of factors that are considered in making compensation decisions, including, but not limited to: education, experience, licensure, certifications, geographic location, and peer compensation. The range has been created in good faith based on information known to Aflac at the time of the posting.

At Aflac, it is not typical for an individual to be hired at or near the top of the range for the role to allow for future and continued salary growth, and compensation decisions are dependent on the circumstances of each case. This salary range does not include any potential incentive pay or benefits, however, such information will be provided separately when appropriate.

In addition to the base salary, we offer an array of benefits to meet your needs including medical, dental, and vision coverage, prescription drug coverage, health care flexible spending, dependent care flexible spending, Aflac supplemental policies (Accident, Cancer, Critical Illness and Hospital Indemnity offered at no costs to employee), 401(k) plans, annual bonuses, and an opportunity to purchase company stock. On an annual basis, you’ll also be offered 11 paid holidays, up to 20 days PTO to be used for any reason, and, if eligible, state-mandated sick leave (Washington employees accrue 1-hour sick leave for every 40 hours worked) and other leaves of absence, if eligible, when needed to support your physical, financial, and emotional well-being. Aflac complies with all applicable leave laws, including, but not limited to, sick and safe leave, and adoption and parental leave, in all states and localities.