Hybrid Senior LTD Case Manager

at Aflac

• Job title: Senior LTD Case Manager
• Job type: Full Time
• Experience level: Senior
• Salary: $65,000 - $85,000 per year
• Degree requirement: High School Diploma
• Location requirements: Hybrid, Farmington, United States

About the role

• Sr LTD Case Manager managing complex long-term disability claims for Aflac, ensuring client satisfaction and compliance. Utilizing strong skills in claims management and customer service to deliver timely decisions.

Responsibilities

• Makes timely, accurate, and customer-focused Long-Term Disability new and ongoing claim decisions on moderately complex to highly complex claims using advanced independent discretion guided by company procedures and regulatory standards; handles the most complex claims from a clinical and financial perspective; reaches out to obtain relevant clinical, vocational, 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
• Documents the claims system in an accurate and comprehensive manner; prepares, updates, and utilizes a claim management plan to attain the most appropriate outcome; remains in full compliance with regulatory requirements; demonstrates an above average level of proficiency in product and claims administration techniques; remains fully compliant with operational standards; meets or exceeds claim team operational metrics
• Maintains a superior level of genuine caring and empathetic customer service throughout all interactions; takes appropriate actions to earn the claimant's and employer's trust and confidence; anticipates customer’s needs and takes action as appropriate
• Works with internal partners to support flexibility, collaboration, creating a positive work environment, consistently maintaining professionalism and integrity, actively taking steps to foster high morale, and demonstrating a dedication to excellence
• Mentors and coaches new team members and participates in projects supporting the team's business initiatives
• Performs other related duties as required

Requirements

• Strong understanding of disability claims management concepts.
• Solid understanding of medical terminology/pathology/anatomy.
• Ability to verbally articulate clearly, concisely and explain complex situations.
• Superior writing skills.
• Confident with independent decision making.
• Ability to consistently meet deadlines.
• Proven ability to work with confidential information.
• Moderate skills with Microsoft Office and other software applications.
• High level of customer service skills/phone skills.
• Strong ability to multi-task and prioritize.
• Must have a high level of attention to detail.
• Results-driven.
• High attention to deliver on departmental/company procedures/practices.
• Ability to work Independently.
• Strong negotiation skills.
• High School Diploma or equivalent.
• 5 or more years of LTD industry claims experience.

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 offered at no costs to employee)
• 401(k) plans
• annual bonuses
• opportunity to purchase company stock
• 11 paid holidays
• up to 20 days PTO to be used for any reason
• if eligible, state-mandated sick leave
• other leaves of absence, if eligible, when needed to support your physical, financial, and emotional well-being