Claims Specialist

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🌴 South Carolina – Remote

🌴 South Carolina – Remote

💵 $35k - $45k / year

⏰ Full Time

🟢 Junior

📋 Claims Specialist

🚫👨‍🎓 No degree required

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Aflac

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1955

💸 Finance

⚕️ Healthcare Insurance

Finance • Healthcare Insurance • Insurance

Aflac is a Fortune 500 company that provides supplemental insurance plans to help cover medical expenses and income loss due to unexpected health issues. Known for its iconic advertisements featuring the Aflac Duck, the company emphasizes employee welfare and offers various career opportunities, including in finance, customer experience, sales, and technology. Aflac operates with a strong commitment to social responsibility and fostering a supportive organizational culture, ensuring that employees feel valued and empowered to contribute to the business' success.

📋 Description

• 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

🎯 Requirements

• High School Diploma or Equivalent • 1 year of work experience • Experience and proficiency using Microsoft Office Suite software • Fluency in Spanish with the ability to translate documents

🏖️ 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 (Washington employees accrue 1-hour sick leave for every 40 hours worked)