[Hiring] Claims Specialist I @Aflac, Incorporated

Role Description

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.

This role is a remote role. This means you will be expected to work from your home, within the continental US. If the role is remote, there may be occasions that you are requested to come to the office based on business need. Any requests to come to the office would be communicated with you in advance.

What does it take to be successful at Aflac?

• Acting with Integrity
• Communicating Effectively
• Pursuing Self-Development
• Serving Customers
• Supporting Change
• Supporting Organizational Goals
• Working with Diverse Populations

What does it take to be successful in this role?

• Knowledge of principles and processes for providing customer and personal services; this includes needs assessment, meeting quality standards for services, and evaluation of customer satisfaction
• Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, and other office procedures and terminology
• Skill in giving full attention to what other people are saying; taking time to understand the points being made; asking questions as appropriate
• Skill in understanding the implications of new information for both current and future problem solving and decision-making
• Skill in using mathematics to solve problems
• Skill in selecting and using training/instructional methods and procedures when learning new policies, procedures, concepts or products
• Skill in managing one’s own time and actively looking for ways to help people
• For positions requiring the use of bilingual skills (if applicable to this position): Fluency in Spanish with the ability to translate documents

Qualifications

• High School Diploma or Equivalent
• 1 year of work experience
• Experience and proficiency using Microsoft Office Suite software
• Or an equivalent combination of education and experience

Requirements

• Experience with medical terminology

Principal Duties & Responsibilities

• Under immediate supervision and in accordance with established policies and procedures, reviews and processes Wellness and Hospital Indemnity insurance claims based on information submitted by policy holders; determines the nature and validity of claims by reviewing policy status, patient eligibility, and supporting medical and other documentation
• Keys claims data while interpreting coding and medical terminology in relation to diagnoses and procedures; uses multiple core administration databases, systems and subsystems to process and transmit claims for payment or further investigation
• Provides prompt customer service to policy holders, providers and other internal company entities regarding claims; documents phone calls in the system and follows-up on issues if needed; contacts insured or other appropriate persons to verify the accuracy and completeness of information on claims forms and related documents, responds to inquiries from policy holders, providers, agents regarding claim status and policy provisions
• Provides back-up coverage for other teams as required, maintains databases and prepares and extracts information using software systems; performs various clerical duties as assigned, such as filing, photocopying, typing, maintaining databases and preparing and extracting information using software systems
• Performs other related duties as required

Benefits

• The salary range for this job is $35,000 to $45,000.
• In addition to the base salary, we offer an array of benefits to meet your needs including:
• Medical, dental, and 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 (Washington employees accrue 1-hour sick leave for every 40 hours worked)
• Other leaves of absence, if eligible
• Aflac complies with all applicable leave laws, including, but not limited to, sick and safe leave, and adoption and parental leave, in all states and localities.