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.

Introduction At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and that’s exactly what you’ll find here. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence. Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you’re here, you’re part of something bigger. You’re part of a team that shows up, stands together, and leads with purpose. Overview Role specifics: - Jurisdictions: Open to any - Licenses: TX FL NY HI RI and reciprocals (must be willing to obtain all licenses within specified timeframe) - Location: This role is eligible for fully remote work. How you'll make an impact - Apply claims management experience to execute decision-making to analyze claims exposure and litigation, plan the proper course of action, and appropriately resolve claims. - Interact extensively with various parties involved in the claim process to ensure effective communication and resolution. - Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process - Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements. - Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file. About You Potential candidates should have the following: - Claims Background: General Liability - Jurisdictional Experience: Open to any - Active Adjusters' licenses: TX FL NY HI RI and reciprocals (must be willing to obtain all licenses within specified timeframe) As a key member of our Claims Adjuster team, you will: - Investigate, evaluate, and resolve complex GL claims, applying your claims experience and analytical skills to make informed decisions and bring claims to resolution. - Work in partnership with our clients to deliver innovative solutions and enhance the claims management process - Think critically, solve problems, plan, and prioritize activities to optimally serve clients REQUIRED QUALIFICATIONS: - High School Diploma. - Minimum of 5 years related claims experience. - Appropriate licensing and/or certification in all states in which claims are being handled. - Knowledge of accepted industry standards and practices. - Computer experience with related claims and business software. DESIRED: - Bachelor's Degree. #LI-SR1 Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve: - Medical/dental/vision plans, which start from day one! - Life and accident insurance - 401(K) and Roth options - Tax-advantaged accounts (HSA, FSA) - Educational expense reimbursement - Paid parental leave Other benefits include: - Digital mental health services (Talkspace) - Flexible work hours (availability varies by office and job function) - Training programs - Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing - Charitable matching gift program - And more... **The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

Introduction At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and that’s exactly what you’ll find here. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence. Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you’re here, you’re part of something bigger. You’re part of a team that shows up, stands together, and leads with purpose. Overview Role specifics: - Jurisdictions: Open to any - Licenses: multi-state adjusters license preferred (TX or FL); must be willing to obtain others required by manager with specified timeframe - Location: This role is fully remote How you'll make an impact - Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims. - Interact extensively with various parties involved in the claim process to ensure effective communication and resolution. - Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process - Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements. - Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file. About You Ideal candidates for this position will have: - Claims Background: Liability - Jurisdictional Experience: Open to any - Active Adjusters' licenses: multi-state adjusters license preferred (TX or FL); must be willing to obtain others required by manager with specified timeframe As a key member of our Claims Adjuster team, you will: - Investigate, evaluate, and resolve General Liability claims, applying your claims experience and analytical skills to make informed decisions and bring claims to resolution. - Work in partnership with our clients to deliver innovative solutions and enhance the claims management process - Think critically, solve problems, plan, and prioritize activities to optimally serve clients REQUIRED QUALIFICATIONS: - High School Diploma. - Minimum of 3 years related claims experience. - Appropriate licensing and/or certification in all states in which claims are being handled. - Knowledge of accepted industry standards and practices. - Computer experience with related claims and business software. DESIRED: - Bachelor's Degree. - Strong customer service experience #LI-SR1 Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve: - Medical/dental/vision plans, which start from day one! - Life and accident insurance - 401(K) and Roth options - Tax-advantaged accounts (HSA, FSA) - Educational expense reimbursement - Paid parental leave Other benefits include: - Digital mental health services (Talkspace) - Flexible work hours (availability varies by office and job function) - Training programs - Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing - Charitable matching gift program - And more... **The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately 2,000 professionals throughout the U.S.—all committed to delivering solutions that change lives for the better. The firm is a member of a family of companies with experience in all 50 states, and clients in three Canadian provinces and Europe. PCG offers clients a multidisciplinary approach to meet challenges, pursue opportunities, and serve constituents across the public sector. To learn more, visit www.publicconsultinggroup.com. Our Education team offers consulting services and technology solutions to help schools, school districts, and state education agencies/ministries of education promote student success, improve programs and processes, and optimize financial resources. We work with clients to ensure all students have what they need to succeed. Services: - Teaching - Learning Solutions - Data Systems - IT Solutions - Financial Solutions - Equity in Education - Equitable Education - Recovery Services The TPA Claiming Lead will lead all efforts of the TPA Claiming Operations Team within the School-Based Services (SBS) Center of Excellence (COE) Operations functional area. This position will direct claims management for TPA models. This role will take ownership for fidelity, efficiency, and optimization in our TPA claiming work. This role must effectively integrate capabilities in claims management, data management, and project management to promote strong collaboration with the Client Success, Technology, and Program Integrity functional areas to execute contractual obligations. The TPA Claiming Lead will also work with Regional Leadership to understand state and local environments, allowing them to effectively implement and expand the PCG claiming operations program.      The ideal candidate should be reflective and thoughtful about PCG’s processes and ready to build and support a team that will develop and implement a consistent, efficient claiming program with capacity for scalable growth and adaptation to meet evolving policies and client needs. Duties and Responsibilities - Analyzes and reviews claims for accuracy, completeness and eligibility. - Provides leadership, supervision and coaching to junior department staff. - Prepares and submits claims data for multiple clients within multiple states. - Analyzes the development of claims assigned at each level of the adjudication process. - Provides support and give direction to less experienced staff - Evaluate medical records and apply evidence to each case. - Provides monthly reporting statistics. - Ensures adherence to claim timeliness and accuracy performance standards. - Prepares for and participate in various meetings, including status reports, process improvement meetings and meetings related to collection of required data. - Conducts policy and other research. - Assists with quality control projects, including case reviews to ensure the integrity of claim methodology and eligibility determinations. - Assists with preparation of other written reports and materials for clients. - Assists in administration of time studies and operation of help desk lines. - Trains others on the function of analyzing claims. Leadership & Oversight - Understand Federal, State, and local Medicaid policies as they pertain to our Education clients and our systems for processing and submitting claims - Seek continuous improvement throughout the service/claim adjudication journey - Represent the TPA team as member of SBS COE leadership team, balancing FFS team needs with broader COE initiatives and efforts   - Act as an escalation point of contact for TPA Claiming Operations - Manage budget and resource leveling for TPA Claiming Operations in support of building PCG’s reputation as a trusted partner  - Solicit feedback from members of the TPA Claiming Operations Team and champion initiatives that address the evolving needs of our clients - Establish best practice models and structures for claims processing and adjudication, including coordinating involvement from other functional areas (e.g., creation of new technical functions)   Skills for Success: - Assists with leading daily and weekly TPA claiming functions - Manages/Oversees the Health-aide prior authorization process - Coordinates and communicates risk and issue escalations - Robust data skills, secure data handling, and understanding of data fidelity best practices - Data analysis skills, especially as it relates to optimization opportunities   - Detailed understanding of Medicaid policy and operations - Effective communication skills (presentation, facilitation, and written)  - Ability to quickly understand and implement new technical and policy requirements - Collaboration skills (with peers, staff, and leadership) and propensity for relationship building  - Team building, staff development, and coaching skills   - Leadership skills, including the ability to be decisive, consistent, transparent, and open to feedback   - Commitment to living and promoting PCG’s values of impact, community, passion and entrepreneurial spirit; and - Professional maturity and ability to put the best interests of the client and PCG above self-interest   Required Skills - Ability to evaluate, coordinate and perform a complex set of planning, development and administrative tasks. - Ability to build and maintain working relationships with federal, state and county agency staff. - Strong Microsoft application skills. - Ability to work with a large volume of claims and effectively prioritize the workload. - Excellent organizational, oral presentation and written communication skills. - Strong analytical skills, including the ability to analyze and organize data. - Existing knowledge or experience with state government, health insurance payment systems (particularly Medicaid), and/or cost accounting are highly advantageous. - Knowledge and understanding of appropriate laws and regulations and applicable government agencies - Overtime and travel might be needed at times. Qualifications - Bachelor’s degree in a relevant field is preferred - 6+ years of relevant claiming experience is required. Previous leadership experience is preferred. Working Conditions - Office Setting- Remote The above is intended to describe the general contents and requirements of work being performed by people assigned to this classification. It is not intended to be construed as an exhaustive statement of all duties, responsibilities or skills of personnel so classified. Compensation: Compensation for roles at Public Consulting Group varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, PCG provides a reasonable range of compensation for this role. In addition, PCG provides a range of benefits for this role, including medical and dental care benefits, 401k, PTO, parental leave, bereavement leave. Range: $68,800 - $94,000 #LI-AH1 #LI-remote PCG does not sponsor newly hired foreign national workers for work authorization, including H-1B sponsorship. EEO Statement: Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.