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PLADS Claims Technical Specialist Job at Aflac, Incorporated

Aflac, Incorporated Remote

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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