Claims Technical Lead

Aflac, Incorporated•Windsor, CT

4d•$75,000 - $95,000•Remote

About The Position

Aflac is hiring a remote Claims Technical Lead to support case managers and claims operations. The role serves as a point of contact for claims questions, mentors and trains new hires, supports refresher training and staff development, and helps ensure appropriate risk management and quality outcomes. The lead also monitors service metrics and workload distribution, supports team meetings, and may manage complex cases and customer escalations. The position is remote within the continental United States, with occasional office visits possible based on business needs.

Requirements

Bachelor’s degree in health administration, business, or a related field, or an equivalent combination of education and experience.
Four or more years of job-related experience, or an equivalent combination of education and experience.
Two years of case management experience in STD/LTD, life, absence management, or a related field or industry.
Ability to influence and champion change.
Excellent critical-thinking and decision-making skills.
Strong leadership and organizational skills.
Excellent verbal, written, and presentation communication skills.
Strong understanding of contracts, plans, and products.
Strong knowledge of best practices and effective case management skills.

Responsibilities

Act as a main point of contact for case managers’ claims-specific questions.
Mentor new hires and support their training.
Participate in refresher training and development for existing staff.
Ensure case managers use appropriate risk management skills to secure appropriate claim outcomes.
Conduct manager reviews and audits of claims as necessary to ensure overall quality.
Provide coaching and feedback to case managers as needed.
Monitor KPIs and reports to ensure service levels and commitments are met, working with case managers as needed.
Monitor and adjust workload balancing for case managers.
Support management in facilitating team meetings and huddles.
Periodically manage complex cases and customer escalations.
Elevate trends and coaching opportunities to the leadership team.
Complete special projects and ad hoc assignments as requested by leadership.
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 to use for any reason
State-mandated sick leave, if eligible
Other leaves of absence, if eligible, including adoption and parental leave