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Aflac

Supplemental health and life insurance provider

Claims Specialist Trainee - Must reside in Nebraska

Claims AdjudicationUpdated on Nov 14
Full-timeRemote in USA

About the Job

Requirements

  • Knowledge of customer and personal service principles and processes, including needs assessment, meeting service quality standards, and evaluating customer satisfaction.
  • Knowledge of administrative and clerical procedures and systems, including word processing, managing files and records, and office procedures and terminology.
  • Ability to listen attentively, understand others’ points, and ask appropriate questions.
  • Ability to understand how new information affects current and future problem-solving and decision-making.
  • Ability to use mathematics to solve problems.
  • Ability to select and use training and instructional methods and procedures when learning new policies, procedures, concepts, or products.
  • Ability to manage personal time and actively look for ways to help people.
  • Fluency in Spanish and ability to translate documents, if bilingual skills are required for the position.
  • High school diploma or equivalent, or an equivalent combination of education and experience.
  • One year of work experience, or an equivalent combination of education and experience.
  • Experience and proficiency using Microsoft Office Suite software, or an equivalent combination of education and experience.

Responsibilities

  • Under immediate supervision and in accordance with established policies and procedures, review and process Wellness, Accident, or Cancer insurance claims based on information submitted by policyholders; determine the nature and validity of claims by reviewing policy status, patient eligibility, and supporting medical and other documentation.
  • Enter claims data while interpreting coding and medical terminology related to diagnoses and procedures; use multiple core administration databases, systems, and subsystems to process and transmit claims for payment or further investigation.
  • Provide prompt customer service to policyholders, providers, and other internal company entities regarding claims; document phone calls in the system and follow up on issues as needed; contact insureds or other appropriate persons to verify the accuracy and completeness of claims forms and related documents; respond to inquiries about claim status and policy provisions.
  • Provide backup coverage for other teams as required; maintain databases and prepare and extract information using software systems; perform clerical duties as assigned, including filing, photocopying, typing, and maintaining databases.
  • Perform other related duties as required.

Desired Qualifications

  • Experience with medical terminology.

About the Company

Aflac

Supplemental health and life insurance provider

Aflac provides supplemental health and life insurance products to individuals and families, operating mainly in two regions: Aflac Japan and Aflac U.S. Its policies are designed to cover out-of-pocket costs from health events and income loss, including cancer, critical illness, accidents, hospital stays, and life events. These benefits are paid directly to policyholders to help manage medical expenses not fully covered by primary insurance. The products are distributed through a network of independent agents, brokers, and financial advisors, enabling a high-volume, low-premium model that supports a large, stable customer base and ongoing revenue. Japan is its largest market, and the company uses this broad distribution and scale to differentiate itself from competitors. The goal is to provide straightforward financial protection against unexpected health-related costs while expanding its presence in the U.S. and Japanese markets.

Company size
10,001+
Company stage
IPO
Headquarters
Columbus, GA
Founded
1955

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