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
Senior Life Case Manager
Location
United States
Posted
9 days ago
Salary
$65K - $85K / year
Seniority
Lead
No structured requirement data.
Job Description
Senior Life Case Manager
Aflac
Title: PLADS Sr Life Case Manager Location: Remote, US, 31999 Workplace: 2203 Job Description: The Company: Aflac Columbus The Location: Remote, US, 31999 The Division: PLADS Job Id: 9339 Salary Range: $65,000 - $85,000 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. 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 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 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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• Effectively manages assigned insurance receivables to achieve business line expectations • Meets productivity standards as outlined by business line • Achieves a minimum of 85% work quality scoring and accuracy on all accounts worked • Completes timely follow-up on assigned accounts to ensure no cash loss • Meets monthly cash expectations as set out for assigned client receivables • Ensures insurance accounts are resolved within 90 days of placement • Demonstrates the ability to prioritize work with some oversight to meet outlined goals • Perform account research and route accounts through appropriate client workflows • Ability to understand, navigate and perform research of account within client host systems • Exceptional understanding of patient accounting systems allowing for ease of transition and learning of new systems as needed by business line • Clearly documents actions taken and next steps for account resolution in patient accounting system • Excellent working knowledge of Prism system and displays clear understanding of claim updates, request workflow, and action step entry into the system • Appropriately makes requests for documentation based on account needs and compliance guidelines • Ability to navigate billing system to perform basic claim billing functions • Clearly prepares appeals for payment to insurance company when appropriate • Ensure strong communication skills to convey intricate account information • Ensure all accounts are worked within client standards and Federal Regulations • Maintain high quality account handling per client standards • Work within federal, state regulations, department/division & all Compliance Policies • Maintain clear, concise, and accurate documentation of all attempts and/or contacts made and received for accounts in accordance with company and client specifications • Maintain continuing education, training in industry career development • Maintain current knowledge of and comply with all federal and state rules and regulations governing phone calls and collections including HIPAA, FDCPA, Privacy Act, FCRA, etc. • Attends training sessions as directed by management • Integrate information obtained through training sessions and policy changes immediately into daily routine
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• Respond to inbound calls, emails, and other inquiries from customers and carriers in a professional manner • Place outbound calls as needed to follow up on customer inquiries • Maintain accurate customer service notes and documentation in the CRM system • Process client requests, policy changes, and updates



