Sr Leave Case Manager - Hybrid; South Portland, ME

Aflac, Incorporated • South Portland, ME

1d • Hybrid

About The Position

We are the duck. We develop and empower our people, cultivate relationships, give back to our community, and celebrate every success along the way. We do it all…The Aflac Way. Aflac, a Fortune 500 company, is an industry leader in voluntary insurance products that pay cash directly to policyholders and one of America's best-known brands. Aflac has been recognized as Fortune’s 50 Best Workplaces for Diversity and as one of World’s Most Ethical Companies by Ethisphere.com. Our business is about being there for people in need. So, ask yourself, are you the duck? If so, there’s a home, and a flourishing career for you at Aflac. This role is hybrid. This means you will be expected to report to our Aflac office located in South Portland, ME for at least 60% of the work week. You will work from your home (within the continental US) for the remaining portion of the work week. Details of this schedule will be discussed with your leadership.

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 data.
• Knowledge of state and federal FMLA regulations; Paid Family and Medical Leave experience a plus.
• Knowledge of medical disability management preferred.
• Strong organizational skills.
• High School Diploma or Equivalent
• 2 or more years of professional job-related experience
• Demonstrated proficiency in product specific areas of absence management and federal and state regulations governing these products and services.
• Or an equivalent combination of education and experience

Nice To Haves

• Associates Degree in a related field

Responsibilities

• Assists and guides claimants with paid leave of absence requests and 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 decisions on new and ongoing absence management claims. Proactively contacts healthcare providers, employers, financial institutions, and other relevant sources to gather information; Evaluates the collected information against contract terms, limitations, conditions, and applicable procedural documents; renders claim decisions promptly to ensure efficient resolutions.
• 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 in handling leave of absence situations by providing guidance consistent with policies and established legal guidelines.
• Keeps complete records of all LOA requests and maintains tracking and analysis of data.
• 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.
• Mentors and coaches new team members and participates in projects supporting the team's business initiatives.
• Supports management with special projects as necessary.
• Assists in process and system assessment, improvement and implementation.
• Performs other duties as assigned.

Benefits

• medical coverage
• dental coverage
• 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
• state-mandated sick leave
• other leaves of absence

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: High school or GED