Claims Technical Lead

Aflac, a Fortune 500 company and industry leader in voluntary insurance products, is known for its commitment to developing and empowering employees, fostering relationships, and supporting communities. This role is remote, based in Windsor, CT, with occasional in-office requests as needed.

About the Role

This position focuses on leadership, mentorship, and quality assurance within case management for short-term disability (STD), long-term disability (LTD), life, and absence management claims. You will act as a key resource for case managers, ensuring adherence to best practices, risk management, and service-level commitments.

Core Values for Success at Aflac

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

Key Success Factors for This Role

• Ability to influence and champion change
• Excellent critical thinking and decision-making skills
• Strong leadership and organizational skills
• Excellent communication skills (verbal, written, and presentation)
• Strong understanding of contracts, plans, and products
• Strong knowledge of best practices and effective case management skills

Requirements

• Bachelor’s degree in health administration, business, or a related field
• 4+ years of job-related experience
• 2+ years of case management experience in STD/LTD, life, absence management, or a related field
• Or an equivalent combination of education and experience

Responsibilities

• Act as the main point of contact for claims-specific questions for case managers
• Mentor new hires and support new-hire training
• Lead refresher training and development for existing staff
• Ensure case managers utilize appropriate risk management skills for optimal claim outcomes
• Conduct manager reviews/audits of claims to ensure quality
• Provide coaching and feedback to case managers as needed
• Monitor KPIs and reports to ensure service levels and commitments are met
• Adjust workload balancing for case managers
• Support management in facilitating team meetings and huddles
• Periodically manage complex cases and customer escalations
• Elevate trends and coaching opportunities to leadership
• Complete special projects and ad hoc assignments as requested
• Perform other related duties as required

Pay

The salary range for this role is $75,000 to $95,000, with offers considering factors such as education, experience, licensure, certifications, geographic location, and peer compensation. Incentive pay or additional benefits may be provided separately when applicable.

Benefits

• Medical, dental, and vision coverage
• Prescription drug coverage
• Health care and dependent care flexible spending accounts
• Aflac supplemental policies (Accident, Cancer, Critical Illness, and Hospital Indemnity offered at no cost to employees)
• 401(k) plans with company match
• Annual bonuses
• Opportunity to purchase company stock
• 11 paid holidays annually
• Up to 20 days of paid time off (PTO) for any reason
• State-mandated sick leave (e.g., Washington employees accrue 1 hour of sick leave for every 40 hours worked)
• Other leaves of absence, as eligible, to support physical, financial, and emotional well-being