Hybrid Leave Case Manager

at Aflac

• Job title: Leave Case Manager
• Job type: Full Time
• Experience level: Junior, Mid level
• Salary: $40,000 - $61,000 per year
• Degree requirement: High School Diploma
• Location requirements: Hybrid, Farmington, United States

About the role

• Claim Manager assisting Aflac with paid leave of absence requests. Processing claims and managing customer communication while ensuring compliance with procedures and regulations.

Responsibilities

• Assists claimants with paid leave of absence requests and guides them through the leave process.
• Processes all leave of absence paperwork according to established procedures and laws.
• Provides timely and accurate responses to associates and all levels of management concerning day-to-day issues and activities.
• Makes timely, accurate, and customer-focused new and ongoing Absence Management claim decisions; reaches out to obtain relevant healthcare provider, employer, financial, and other information; compares the information to the terms, limitations, and conditions of the contract/administrative services agreement and applicable procedural documents and renders the claim decision as quickly as possible.
• Makes recommendations to approve or deny requests for Statutory Paid Leave based on state regulations.
• Coordinates correspondence, forms, and other documents via the claim system; documents the claims system in an accurate and comprehensive manner.
• Generates reports as required; maintains files, inputs and analyzes data.
• Assists management with leave of absence situations and provides guidance within the policy and established legal guidelines.
• Keeps complete records of all LOA requests and maintains tracking and analysis of data.
• Participates in developing goals, objectives, and systems.
• Maintains compliance with standards and federal/state regulations.
• Serves as an internal reference to the team for certification requirements and processing.
• Contacts Providers for clarification.
• Supports management with special projects, as necessary.
• Performs other duties as assigned.

Requirements

• Current knowledge of the absence management industry
• Excellent customer service skills and ability to manage difficult and stressful situations
• Strong communication skills – written, verbal, persuasion, motivation, facilitation of strong working relationships
• Ability to manage business expectations and resolve concerns, by communicating status and issues
• Ability to effectively prioritize and escalate customer issues
• Ability to interpret and analyze multiple facts
• Knowledge of state and federal FMLA regulations; Paid Family and Medical Leave experience a plus
• Knowledge of medical disability management preferred
• Strong organizational skills
• Excellent interpersonal skills
• Ability to work in a team environment
• Ability to meet or exceed performance competencies
• High School Diploma or Equivalent

Benefits

• 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)
• 401(k) plans
• annual bonuses
• opportunity to purchase company stock
• 11 paid holidays
• up to 20 days PTO
• state-mandated sick leave as applicable