Sr LTD Case Manager

Claims SpecialistClaims SpecialistFull TimeRemoteLeadTeam 10,001

Location

United States

Posted

4 days ago

Salary

$65K - $85K / year

Seniority

Lead

Job Description

Salary Range: $65,000 - $85,000

Job Posting End Date: This job will be posted on an ongoing basis.

 

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 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?

• Strong understanding of disability claims management concepts.

 

• Solid understanding of medical terminology/pathology/anatomy.

 

• Ability to verbally articulate clearly, concisely and explain complex situations.

 

• Superior writing skills.

 

• Confident with independent decision making.

 

• Ability to consistently meet deadlines.

 

• Proven ability to work with confidential information.

 

• Moderate skills with Microsoft Office and other software applications.

 

• High level of customer service skills/phone skills.

 

• Strong ability to multi-task and prioritize.

 

• Must have a high level of attention to detail.

 

• Results-driven.

 

• High attention to deliver on departmental/company procedures/practices.

 

• Ability to work Independently.

 

• Strong negotiation skills.

 

Education & Experience Required

  • High School Diploma or equivalent
  • 5 or more years of LTD industry claims experience.
  • Demonstrated proficiency in product specific areas of STD, LTD or Account Management, and federal and state regulations governing these products and services

Or an equivalent combination of education and experience

 

Education & Experience Preferred

  • Bachelor's Degree Business, or healthcare related field
  • 4 or more years of experience in disability management industry managing claims

 

Principal Duties & Responsibilities

• Makes timely, accurate, and customer-focused Long-Term Disability new and ongoing claim decisions on moderately complex to highly complex claims using advanced independent discretion guided by company procedures and regulatory standards; handles the most complex claims from a clinical and financial perspective; reaches out to obtain relevant clinical, vocational, employer, financial, and other information; compares the information to the terms, limitations, and conditions of the contract/administrative services agreement 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 claim 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 claim team operational metrics

 

• Maintains a superior 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

The salary range for this job is $65,000 to $85,000. 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.

 

 

 

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