Leave Case Manager (Hybrid; Must Reside in CT)
Aflac is a Fortune 500 company and an industry leader in voluntary insurance products. The Leave Case Manager will assist claimants with paid leave of absence requests, process necessary paperwork, and ensure compliance with state and federal regulations while providing excellent customer service.
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
Skills
- 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
- High School Diploma or Equivalent
- 1 - 2 years of professional job-related experience
- Or an equivalent combination of education and experience
- Associates Degree
- Demonstrated proficiency in product specific areas of Absence Management and federal and state regulations governing these products and services
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 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
- Sick and safe leave
- Adoption and parental leave
Company Overview