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Aflac logo
Aflac

Aflac, American Family Life Assurance Company, was founded in 1955 by brothers William, John, and Paul Amos. Today, Aflac is a Fortune 500 company and the large

Claims Specialist

Location

South Carolina

Posted

36 days ago

Salary

$35K - $45K / year

Seniority

Junior

High School1 yr expSpanishEnglish

Job Description

Claims Specialist

Aflac

• reviews and processes Wellness and Hospital Indemnity insurance claims based on information submitted by policy holders • determines the nature and validity of claims by reviewing policy status, patient eligibility, and supporting medical and other documentation • keys claims data while interpreting coding and medical terminology in relation to diagnoses and procedures • uses multiple core administration databases, systems and subsystems to process and transmit claims for payment or further investigation • provides prompt customer service to policy holders, providers and other internal company entities regarding claims • documents phone calls in the system and follows-up on issues if needed • contacts insured or other appropriate persons to verify the accuracy and completeness of information on claims forms and related documents • responds to inquiries from policy holders, providers, agents regarding claim status and policy provisions • provides back-up coverage for other teams as required • maintains databases and prepares and extracts information using software systems • performs various clerical duties as assigned, such as filing, photocopying, typing, maintaining databases and preparing and extracting information using software systems

Job Requirements

  • High School Diploma or Equivalent
  • 1 year of work experience
  • Experience and proficiency using Microsoft Office Suite software
  • Fluency in Spanish with the ability to translate documents

Benefits

  • 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
  • opportunity to purchase company stock
  • 11 paid holidays
  • up to 20 days PTO to be used for any reason
  • state-mandated sick leave (Washington employees accrue 1-hour sick leave for every 40 hours worked)

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