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PLADS Claims Technical Specialist

Remote -
Full time
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Insurance & superannuation
5,001-10,000 employees
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Salary Range: $40,000 - $95,000

Remote/Hybrid/On-Site: Remote

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

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 designated as a remote role. You will be expected to work from your home, within the continental US. Although this role is designated as 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?

  • Ability to influence and champion change

  • Excellent critical thinking and decision -making skills

  • Strong leadership and organizational skills

  • Excellent Communication skills (verbal, written & presentation)

  • Strong understanding of contracts, plans and products

  • Strong knowledge of best practices and effective case management skills

Education & Experience Required

  • Bachelor's Degree In a related field
  • 5 years minimum LTD industry experience
  • 2 years minimum experience working with employees

Or an equivalent combination of education and experience

Principal Duties & Responsibilities

  • Acts as a main point of contact for claims specific questions for the case managers

  • Serves as a mentor for new hires as well as supports new hiring training

  • Takes an active role in refresher training and developing of existing staff

  • Ensures case managers are utilizing appropriate risk management skills to secure the appropriate claim outcome

  • Conducts manager reviews/ audits of claims as necessary to ensure overall quality

  • Provides the appropriate coaching and feedback to case managers as needed

  • Monitors KPIs and reports to ensure service levels and commitments are met, working with case managers as needed

  • Monitors and adjusts workload balancing for case managers

  • Provides support to the manager in facilitating team meetings/ huddles

  • May periodically manage very complex cases directly

  • Elevates any trends and / or coaching opportunities to the leadership team

  • May manage customer escalations

  • Completes special projects and/or ad hoc assignments as requested by the leadership team

  • Performs other related duties as required

Total Rewards

This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. The range has been created in good faith based on information known to Aflac at the time of the posting. 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. The salary range for this position is $75,000 to $85,000.

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.