Salary Range: $31,200 to $68,000

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. 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 an onsite role. You will be required to work at the Aflac Group Building Laurel Street in Columbia, SC during your set working schedule.

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?

• Knowledge of principles and processes for providing customer and personal services; this includes needs assessment, meeting quality standards for services, and evaluation of customer satisfaction

• Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, and other office procedures and terminology

• Skill in giving full attention to what other people are saying; taking time to understand the points being made; asking questions as appropriate

• Skill in understanding the implications of new information for both current and future problem solving and decision-making
  • Skill in using mathematics to solve problems

• Skill in selecting and using training/instructional methods and procedures when learning new policies, procedures, concepts or products

• Skill in managing one’s own time and the time of others and actively looking for ways to help people

• Positions requiring the use of bilingual skills: Fluency in Spanish with the ability to translate documents

Education & Experience Required

• High school diploma or equivalent
• 2 years job related experience
• Experience and proficiency using Microsoft Office Suite Software

Or an equivalent combination of education and experience

Education & Experience Preferred

• ICD/CPT coding knowledge
• Experience with medical terminology and human anatomy

Principal Duties & Responsibilities

• Under general supervision and in accordance with established policies and procedures, reviews and processes insurance claims (Wellness, Accident, and Hospital Indemnity)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
  • Communicates customer inquiries to management to provide information for improvement of overall service levels; manages claim risk exposure; reviews and assesses existing work processes and recommends process improvements or enhancements

• Reviews medical chart notes, provider bills, procedure codes, diagnosis codes, charges and medical records in order to determine validity of accident claim; collects needed information, researches diagnoses, procedures, ad eligibility for payment under accident policy

• 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

• As assigned, supports EXL with non-routine Claims, researching missing or inaccurate information; provides other administrative support to EXL as needed

• As assigned, assists with Electronic Fund Transfer setup/maintenance and keeps records of all EFT entries; audits accuracy of EXL production

• Assists with successful transition of new employees from training to the work environment; addresses situations escalated from less experienced specialists and escalates as necessary to lead specialist

• 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 $31,200 to $68,000.

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.