A

Aflac

Supplemental health and life insurance provider

Sr LTD Case Manager - Must Reside in Nebraska

Claims AdjudicationUpdated on Nov 14
Full-timeRemote in USA$65k - $85k

About the Job

Requirements

  • Strong understanding of disability claims management concepts.
  • Solid understanding of medical terminology, pathology, and anatomy.
  • Ability to clearly and concisely explain complex situations verbally.
  • Superior writing skills.
  • Confident independent decision-making ability.
  • Ability to consistently meet deadlines.
  • Proven ability to work with confidential information.
  • Moderate skills with Microsoft Office and other software applications.
  • High level of customer service and phone skills.
  • Strong ability to multitask and prioritize.
  • High attention to detail.
  • Ability to deliver on departmental and company procedures and practices.
  • Ability to work independently.
  • Strong negotiation skills.
  • High school diploma or equivalent.
  • Five or more years of long-term disability industry claims experience.
  • Demonstrated proficiency in product-specific areas of short-term disability, long-term disability, or account management, and in federal and state regulations governing these products and services.
  • Or an equivalent combination of education and experience.

Responsibilities

  • Make timely, accurate, customer-focused decisions on moderately complex to highly complex new and ongoing long-term disability claims, using independent discretion guided by company procedures and regulatory standards; handle the most complex claims from clinical and financial perspectives; obtain relevant clinical, vocational, employer, financial, and other information; compare information with contract or administrative services agreement terms, limitations, conditions, and applicable procedures; and render claim decisions promptly.
  • Document the claims system accurately and comprehensively; prepare, update, and use a claim management plan to attain the most appropriate outcome; comply with regulatory requirements and operational standards; demonstrate proficiency in product and claims administration techniques; and meet or exceed claim team operational metrics.
  • Provide genuine, empathetic customer service throughout interactions; take appropriate actions to earn claimant and employer trust and confidence; and anticipate and address customer needs.
  • Work with internal partners to support flexibility and collaboration, create a positive work environment, maintain professionalism and integrity, foster high morale, and demonstrate dedication to excellence.
  • Mentor and coach new team members and participate in projects supporting the team's business initiatives.
  • Perform other related duties as required.

Desired Qualifications

  • Bachelor's degree in Business or a healthcare-related field.
  • Four or more years of experience managing claims in the disability management industry.

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

Recently Posted Jobs

Explore more opportunities at Aflac

See more jobs