LTD Case Manager I

AFLAC, INCORPORATED.; Windsor (CT); Remote; USD 50,000 - 60,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Prescription drug coverage

Health care flexible spending accounts

Dependent care flexible spending

Aflac supplemental policies

Job summary

Aflac, a Fortune 500 company, is seeking a disability claims professional to manage routine and less complex long-term disability cases. You will evaluate information, render timely decisions, and maintain strict confidentiality and regulatory compliance.

This remote role supports the continental US, with training and development opportunities to grow expertise in claim management and customer service. Strong communication, organization, and Microsoft Office skills are essential.

Qualifications

• High School Diploma or Equivalent.
• 0–2 years of professional work experience.
• Or an equivalent combination of education and experience.
• Bachelor's Degree in Business, Healthcare, Human Services, Psychology, or a related field.

Responsibilities

• Manages an assigned caseload of routine and less complex long-term disability claims and renders timely claim decisions within established guidelines and authority levels.
• Evaluates clinical, vocational, employer, financial, and other claim-related information to determine benefit eligibility based on policy provisions, claim facts, and departmental procedures.
• Participates in formal training and development activities to build proficiency in disability claim management, policy interpretation, regulatory requirements, and customer service practices.
• Develops claim management skills through coaching, mentoring, and regular consultation with peers and leadership.
• Documents claim activity, analysis, and decisions accurately and comprehensively within claim systems.
• Communicates professionally and empathetically with claimants, employers, healthcare providers, and internal partners regarding claim requirements, status, and decisions.
• Maintains compliance with operational, regulatory, and quality standards while developing proficiency in claim administration practices.
• Assumes greater claim complexity and decision-making responsibility as proficiency is demonstrated.
• Does other related duties as required.

Skills

Analytical skills

Verbal and written communication

Customer service

Organizational skills

Confidentiality and compliance

Microsoft Office

Education

High School Diploma or Equivalent

0–2 years of professional work experience

Bachelor's Degree in Business, Healthcare, Human Services, Psychology, or a related field

Tools

Microsoft Office

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 learn and apply policies, procedures, guidelines, and regulatory requirements.
• Analytical skills with strong attention to detail.
• Ability to evaluate information and make sound decisions with guidance as needed.
• Effective verbal and written communication skills.
• Strong organizational, prioritization, and time-management skills.
• Customer service and interpersonal skills.
• Ability to maintain confidentiality and compliance standards.
• Proficiency with Microsoft Office applications and the ability to learn business systems.

Education & Experience Required

• High School Diploma or Equivalent
• 0 – 2 years of professional work experience.

Or an equivalent combination of education and experience

Education & Experience Preferred

• Bachelor's Degree Business, Healthcare, Human Services, Psychology, or a related field
• Experience reviewing information and applying policies, procedures, guidelines, or regulatory requirements to support claim, case, or eligibility decisions.

• Manages an assigned caseload of routine and less complex long-term disability claims and renders timely claim decisions within established guidelines and authority levels.
• Evaluates clinical, vocational, employer, financial, and other claim-related information to determine benefit eligibility based on policy provisions, claim facts, and departmental procedures.
• Participates in formal training and development activities to build proficiency in disability claim management, policy interpretation, regulatory requirements, and customer service practices.
• Develops claim management skills through coaching, mentoring, and regular consultation with peers and leadership.
• Documents claim activity, analysis, and decisions accurately and comprehensively within claim systems.
• Communicates professionally and empathetically with claimants, employers, healthcare providers, and internal partners regarding claim requirements, status, and decisions.
• Maintains compliance with operational, regulatory, and quality standards while developing proficiency in claim administration practices.
• Assumes greater claim complexity and decision-making responsibility as proficiency is demonstrated.
• Does other related duties as required.

Total Rewards

The salary range for this job is $50,000 - $60,000. 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.