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Mgr, PLADS Claims Operations

AFLAC locationFarmington, CT
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51 positions
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51 positions
info linkReport a probelm Originally Posted : September 22, 2021 | Expires : October 22, 2021

Details

Salary
Unspecified
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Job Location
Farmington, CT, United States

Description

Opportunity: Mgr, PLADS Claims Operations

Location(s): CT-Minerva

Job Summary

Manager of a front line claims operational team is responsible for the direct supervision of Case Managers, operational results, and performance of those Case Managers. Also involved in direct customer and sales interaction as it relates to our process and case management.

Principal Duties & Responsibilities

  • Oversees daily operations of multiple levels of staff and multiple functions across one or more business units

  • Manages day to day site operations and accountability for financial and non-financial results (budgets and actuals)

  • Provides expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing, and adjusting claims

  • Attends/participates in select customer meetings as appropriate to discuss feedback and/or needed process enhancements

  • Initiates and maintains partnerships with others throughout the organization

  • Encourages cooperation by promoting common goals and building trust

  • Inspires, supports, and initiates cross-functional activities

  • Authorizes the appropriate payment or refers claims to investigators for further review

  • Analyzes and identifies trends and provides reports as necessary

  • Leads project management and implementation initiatives

  • Supports employee development by conducting regularly scheduled 1x1s with direct reports

  • Provides appropriate oversight to ensure team successfully achieves targets to meet performance guarantees

  • Performs other related duties as required

Education & Experience

Bachelors Degree in a related field, and 5+ years of claims industry experience, or an equivalent combination of education and experience.

5+ years of Supervisory, Managerial, and / or leadership experience in claims adjudication or customer service (Required)

2+ years of experience managing relationships with clients and / or vendors (Required)

2+ years of experience managing budgets, process improvement and quality

assurance (Required)

Proficiency within Microsoft Excel (ability to create pivot tables, basic formulas, sorting, and read data)

(Required)

Proficiency within Microsoft Excel (ability to create pivot tables, basic formulas, sorting, and read data) (Preferred)

Job Knowledge & Skills

  • Ability to be proactive

  • Sense of Urgency

  • Time Management Skills

  • Ability to follow through with daily tasks

Competencies

  • Acting with Integrity - Clearly states goals and beliefs; lets people know his/her true intentions; does what he she said they would do; follows through on commitments

  • Communicating Effectively - Expresses ideas and information in a clear and concise manner; tailors message to fit the interests and needs of the audience; delivers information in a manner that is interesting and compelling to the listener

  • Pursuing Self-Development - Demonstrates ambition and desire to move forward in his/her career; engages others in discussions about career development; seeks feedback on ways to increase his/her performance; takes advantage of opportunities to build new skills and capabilities

  • Serving Customers - Builds strong relationships with customers; stays aware of customer needs, concerns and satisfaction; responds promptly to customer questions and requests; effectively manages

  • Supporting Change - Enthusiastically participates in new change initiatives and programs; focuses on reasons why changes will work and how they will be beneficial

  • Supporting Organizational Goals - Actively supports organizational goals and values; demonstrates enthusiasm toward the companys goals and mission; aligns actions around organizational goals

  • Working with Diverse Populations - Shows respect for the beliefs and traditions of others; encourages and promotes practices that support cultural diversity; discourages behaviors or practices that may be perceived as unfair, biased, or critical toward people with certain backgrounds

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