Claims Technical Lead

Aflac Incorporated; Windsor (CT); Remote; USD 75,000 - 95,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

401(k)

Annual bonus potential

Stock purchase option

11 paid holidays

Up to 20 days PTO

Sick leave where applicable

Job summary

Aflac Incorporated in Windsor, CT offers a remote role focused on claims management and leadership within STD/LTD, Life, and absence management. You will act as the main contact for claims questions, mentor new hires, and drive process improvements while upholding high service standards.

Preferred candidates hold a bachelor’s degree in health administration or related field, with 4+ years of experience and at least 2 years in case management.

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 a related field/industry.
• Or an equivalent combination of education and experience.

Responsibilities

• Act as main point of contact for claims questions for case managers.
• Mentor new hires and support training activities.
• Provide refresher training and develop existing staff.
• Ensure case managers use risk management skills to secure appropriate claim outcomes.
• Conduct manager reviews/audits to ensure overall quality.
• Coach and provide feedback, monitor KPIs and service levels, adjust workload balancing.
• Support management in team meetings and huddles; handle complex cases and escalations.

Skills

Communication skills

Leadership

Critical thinking

Contract / plans knowledge

Education

Bachelor’s degree in Health administration, Business, or related field

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 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, ora 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 to $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