Mgr, PLADS LTD Claims


Location: Remote - US only

Job Type: Full time


Salary Range: $80,000 - $185,000

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

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 as a Champion for Change
  • Acting with Integrity
  • Communicating Effectively
  • Demonstrating Initiative
  • Developing Talent
  • Managing Performance
  • Pursuing Self-Development
  • Serving Customers
  • Supporting Change
  • Supporting Organizational Goals
  • Working with Diverse Populations

What does it take to be successful in this role?

  • Desired designations include: ICA (Insurance Claims Associate); HIA (Health Insurance Associate); LOMA, FLMI (Fellow Life Management Institute); CEBS (Certified Employee Benefit Specialist); etc.

Education & Experience Required

  • Bachelor's Degree In a related field
  • 5+ years of LTD claims industry experience
  • 5+ years of Supervisory, Managerial, and / or leadership experience in claims adjudication or customer service
  • 2+ years of experience managing relationships with clients and / or vendors
  • 2+ years of experience managing budgets, process improvement and quality assurance

Or an equivalent combination of education and experience

Principal Duties & Responsibilities

  • Oversees daily operations of multiple LTD Claims functions

  • Ensures the team provides excellent customer service by appropriately adjudicating claims within established service protocols

  • Responds to and documents customer complaints from claimants/their representative, clients, and policyholders

  • Ensures quality claim decisions in accordance with ERISA requirements and fair claim practices

  • Consistently adheres to the documented workflow guidelines and established procedures

  • Ensures consistent, quality claims handling of pending claims

  • Responds to and tracks all Insurance Department complaints

  • Actively participates in review of escalated claims for approvals/denials

  • Conducts one-on-one meetings with all claims staff to ensure alignment

  • Conducts timely, accurate performance assessments for all team members

  • Partners with others in mentoring all staff to acceptable proficiency levels

  • Documents and addresses all performance management issues and communicates those to the Director of Claims

  • Interfaces weekly with Client Liaison to remain abreast of team member performance and on-going training needs

  • Monitors caseloads to maintain consistency within team

  • Analyzes claim activity reports to ensure adherence to turn-around times, workflow guidelines, etc.

  • Supports/develops supervisors’ technical and mentoring capabilities

  • Participates in customer presentations and visits with the goal of retaining existing customers and attaining new customers at the request of the Director of Claims

  • Participates in cross-departmental initiatives to enhance the overall effectiveness of the company at the request of the Director of Claims

  • Reaches or exceeds approved quality rating requirements

  • Displays a high level of leadership through employee development, coaching and performance management; provides leadership and coaching to claims staff and maintains a positive impact on employee staffing and retention levels by participating in recruiting, hiring and retention strategies

  • 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 $80,000 to $185,000.

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.