Sr Life Case Manager
Remote, US, 31999
Salary Range: $42,000 - $98,000
Job Posting End Date: November 30, 2024
We’ve Got You Under Our Wing
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 designated as a remote role. You will be expected to work from your home, within the continental US. Although this role is designated as 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.
Job Summary
Handles a complex case load of Group Life and Accidental death claims. Makes timely, accurate, and customer-focused claim decisions. Serves as resource and mentor for other team members. Proactively engages legal, compliance, employer, and other informational internal and external sources to gather relevant data, and compares it to the applicable contract and procedures. Conducts an analysis of data and engages peers and management as appropriate. Communicates verbally and in writing an accurate and comprehensive decision. Maintains performance at or above departmental metrics.
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?
• Strong familiarity with claim management concepts
• Strong understanding of medical terminology/pathology/anatomy
• Articulate verbal and writing skills, decision making, meeting deadlines, working with confidential information
• Strong skills with Microsoft Office and other software applications
• Ability to multi-task and prioritize
• High level of attention to detail
• High attention to departmental/company procedures/practices
Education & Experience Required
- High School Diploma or Equivalent
- 3 - 5 years of Life industry claims experience
- Demonstrated proficiency in product specific areas of Life or Disability as well as federal and state regulations governing these products and services
Or an equivalent combination of education and experience
Education & Experience Preferred
- Bachelor's Degree In a related field
Principal Duties & Responsibilities
• Makes timely, accurate, and customer-focused life, accident, new and ongoing claim decisions using advanced independent discretion, guided by company procedures and regulatory standards; handles complex claims; obtains relevant medical, legal , employer, financial, and other information; compares the information to the terms, limitations, and conditions of the contract and applicable procedural documents, and renders the claim decision as quickly as possible.
• Documents the claims system in an accurate and comprehensive manner; prepares, updates, and utilizes a claims management plan to attain the most appropriate outcome; remains in full compliance with regulatory requirements; demonstrates an above average level of proficiency in product and claims administration techniques; remains fully compliant with operational standards; meets or exceeds claims team operational metrics.
• Maintains a level of genuine caring and empathetic customer service throughout all interactions; takes appropriate actions to earn the claimant's and employer's trust and confidence; anticipates customer’s needs and takes action as appropriate
• Works with internal partners to support flexibility, collaboration, creating a positive work environment, consistently maintaining professionalism and integrity, actively taking steps to foster high morale, and demonstrating a dedication to excellence
• Mentors and coaches new team members and participates in projects supporting the team's business initiatives.
• Performs other related duties as required.
Total Rewards
This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. The range has been created in good faith based on information known to Aflac at the time of the posting. 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. The salary range for this position is $42,000 to $98,000.
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.
Apply
Job Profile
Occasional office visits may be required
Benefits/PerksAflac supplemental policies Annual bonuses Career development Community engagement Paid holidays Prescription drug coverage Remote work State mandated sick leave Supplemental policies Total Rewards Vision coverage
Tasks- Collaboration
- Development
- Document claims system
- Ensure compliance
- Handle complex claims
- Make claim decisions
- Prepare claims management plan
Analysis Anatomy Attention to detail Claim Management Claims management Collaboration Compliance Confidential information handling Customer service Data analysis Decision making Diversity Flexibility Insurance Products Medical terminology Microsoft Office Multi-tasking Organizational Self-development Software Writing
Experience3 - 5 years
EducationBachelor's degree Business Diploma Equivalent Health Care High school diploma High school diploma or equivalent Legal Management Related Field
TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9