PLADS Claims Technical Specialist
Aflac
Job Summary
Serves as the claim and/or leave subject matter expert providing support to the Operations leadership team as well as a mentor for case managers.
Principal Duties & Responsibilities
• Acts as a main point of contact for claims specific questions for the case managers
• Serves as a mentor for new hires as well as supports new hiring training
• Takes an active role in refresher training and developing of existing staff
• Ensures case managers are utilizing appropriate risk management skills to secure the appropriate claim outcome
• Conducts manager reviews/ audits of claims as necessary to ensure overall quality
• Provides the appropriate coaching and feedback to case managers as needed
• Monitors KPIs and reports to ensure service levels and commitments are met, working with case managers as needed
• Monitors and adjusts workload balancing for case managers
• Provides support to the manager in facilitating team meetings/ huddles
• May periodically manage very complex cases directly
• Elevates any trends and / or coaching opportunities to the leadership team
• May manage customer escalations
• Completes special projects and/or ad hoc assignments as requested by the leadership team
• Performs other related duties as required
Education & Experience Required
- Minimum Required Bachelor’s Degree In a related field.
- Minimum Required 5-year minimum STD industry experience
- Minimum Required 2 years minimum experience working with employees
Or an equivalent combination of education and experience
Job Knowledge & Skills
• Ability to influence and champion change
• Excellent critical thinking and decision -making skills
• Strong leadership and organizational skills
• Excellent Communication skills (verbal, written & presentation)
• Strong understanding of contracts, plans and products
• Strong knowledge of best practices and effective case management skills
Competencies
- Acting with Integrity
- Communicating Effectively
- Pursuing Self-Development
- Serving Customers
- Supporting Change
- Supporting Organizational Goals
- Working with Diverse Populations
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