Claims Specialist Trainee (Must reside in Nebraska)
About The Position
Aflac is hiring a remote Claims Specialist Trainee who must reside in Nebraska. Under immediate supervision and established policies and procedures, the trainee reviews and processes Wellness, Accident, or Cancer insurance claims based on information submitted by policyholders. The role determines the nature and validity of claims by reviewing policy status, patient eligibility, and supporting medical and other documentation. The position enters claims data, interprets coding and medical terminology related to diagnoses and procedures, and uses multiple administration databases and systems to process and transmit claims for payment or further investigation. It also provides prompt service to policyholders, providers, agents, and internal company entities; documents calls; follows up on issues; verifies claim information; and responds to questions about claim status and policy provisions. The trainee may provide backup coverage for other teams, maintain databases, prepare and extract information using software systems, and perform clerical duties. The role is remote from the employee’s home within the continental United States, with possible advance-notice requests to come to an office based on business needs.
Requirements
- High school diploma or equivalent.
- At least 1 year of work experience.
- Experience and proficiency using Microsoft Office Suite software.
- An equivalent combination of education and experience may be considered.
- Must reside in Nebraska.
- For positions requiring bilingual skills, fluency in Spanish and the ability to translate documents.
Nice To Haves
- Experience with medical terminology.
Responsibilities
- Review and process Wellness, Accident, or Cancer insurance claims under established policies and procedures.
- Determine the nature and validity of claims by reviewing policy status, patient eligibility, and supporting medical and other documentation.
- Enter claims data and interpret coding and medical terminology related to diagnoses and procedures.
- Use core administration databases, systems, and subsystems to process and transmit claims for payment or further investigation.
- Provide prompt customer service to policyholders, providers, and internal company entities regarding claims.
- Document phone calls, follow up on issues, and contact insured individuals or other appropriate persons to verify the accuracy and completeness of claim information and related documents.
- Respond to inquiries from policyholders, providers, and agents regarding claim status and policy provisions.
- Provide backup coverage for other teams as required.
- Maintain databases and prepare and extract information using software systems.
- Perform assigned clerical duties, including filing, photocopying, typing, and database maintenance.
- Perform other related duties as required.
Benefits
- Medical coverage
- Dental coverage
- Vision coverage
- Prescription drug coverage
- Health care flexible spending account
- Dependent care flexible spending account
- Aflac supplemental Accident, Cancer, Critical Illness, and Hospital Indemnity policies at no cost to the employee
- 401(k) plans
- Annual bonuses
- Opportunity to purchase company stock
- 11 paid holidays annually
- Up to 20 days of PTO for any reason
- State-mandated sick leave, if eligible
- Other leaves of absence, if eligible
- Adoption and parental leave in accordance with applicable laws
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
