Leave Case Manager

About the role

This role is hybrid, requiring you to report to one of our Aflac offices located in Windsor, CT, for at least 60% of the work week, with the remainder worked from your home within the continental US.

Responsibilities

• Assists claimants with paid leave of absence requests and guides them through the leave process.
• Processes all leave of absence paperwork according to established procedures and laws.
• Provides timely and accurate responses to associates and all levels of management concerning day-to-day issues and activities.
• Makes timely, accurate, and customer-focused new and ongoing Absence Management claim decisions; reaches out to obtain relevant healthcare provider, employer, financial, and other information; compares the information to the terms, limitations, and conditions of the contract/administrative services agreement and applicable procedural documents and renders the claim decision as quickly as possible.
• Makes recommendations to approve or deny requests for Statutory Paid Leave based on state regulations.
• Coordinates correspondence, forms, and other documents via the claim system; documents the claims system in an accurate and comprehensive manner.
• Generates reports as required; maintains files, inputs and analyzes data.
• Assists management with leave of absence situations and provides guidance within the policy and established legal guidelines.
• Keeps complete records of all LOA requests and maintains tracking and analysis of data.
• Participates in developing goals, objectives, and systems.
• Maintains compliance with standards and federal/state regulations.
• Serves as an internal reference to the team for certification requirements and processing.
• Contacts Providers for clarification.
• Supports management with special projects, as necessary.
• Performs other duties as assigned.

Requirements

• High School Diploma or Equivalent
• 1 - 2 years of professional job-related experience
• Or an equivalent combination of education and experience

Qualifications

• Current knowledge of the absence management industry.
• Excellent customer service skills and ability to manage difficult and stressful situations.
• Strong communication skills – written, verbal, persuasion, motivation, facilitation of strong working relationships.
• Ability to manage business expectations and resolve concerns, by communicating status and issues.
• Ability to effectively prioritize and escalate customer issues.
• Ability to interpret and analyze multiple facts.
• Knowledge of state and federal FMLA regulations; Paid Family and Medical Leave experience a plus.
• Knowledge of medical disability management preferred.
• Strong organizational skills.
• Excellent interpersonal skills.
• Ability to work in a team environment.
• Ability to meet or exceed performance competencies

Skills

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

Pay

$40,000 - $58,000

Benefits

• 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 cost to employee)
• 401(k) plans
• Annual bonuses
• Opportunity to purchase company stock
• 11 paid holidays annually
• Up to 20 days PTO to be used for any reason
• State-mandated sick leave where applicable (Washington employees accrue 1-hour sick leave for every 40 hours worked)
• Other leaves of absence, if eligible, when needed to support your physical, financial, and emotional well-being