Senior STD Case Manager
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Job Description
Senior Claims Manager at Aflac making customer-focused decisions on STD and AM claims. Ensuring compliance and maintaining superior customer service throughout all interactions.
Responsibilities:
- Makes timely, accurate, and customer-focused STD and AM new and ongoing claim decisions 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 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
- Maintains a superior level of genuine caring and empathetic customer service throughout all interactions
- Works with internal partners to support flexibility, collaboration, and creating a positive work environment
- Mentors and coaches new team members and participates in projects supporting the team's business initiatives
Requirements:
- High School Diploma or equivalent
- 3 - 5 years of STD Industry claims management experience
- Demonstrated proficiency in product specific areas of STD, LTD or AM as well as federal and state regulations governing these products and services
- Strong familiarity with disability 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
- Customer service skills
- Stress tolerance
- Math skills
- Ability to multi-task and prioritize
- High level of attention to detail
- Can work under pressure
- Confidence to make claim decisions
- Results-driven
- High attention to departmental/company procedures/practices
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
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