PLADS Claims Technical Specialist Job at Aflac, Incorporated
Job Summary
Serves as the claim and/or leave subject matter expert providing support to the Operations leadership team as well as a mentor for case managers.
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
Education & Experience Required
- Minimum Required Bachelor’s Degree In a related field.
- Minimum Required 5-year minimum industry experience
- Minimum Required 2 years minimum experience working with employees
Or an equivalent combination of education and experience
Job Knowledge & Skills
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
Competencies
Acting with Integrity- Communicating Effectively
- Pursuing Self-Development
- Serving Customers
- Supporting Change
- Supporting Organizational Goals
- Working with Diverse Populations
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