Aflac · 17 hours ago
Case Verification Manager (PLADS Maine Paid Leave)
South Portland, ME, US, 04106
Full-time
Hybrid
Mid Level
$50K/yr - $70K/yr
3+ years expAflac is a Fortune 500 company and an industry leader in voluntary insurance products. The Case Verification Manager will be responsible for reviewing and investigating claims for potential misrepresentation, maintaining reports, and serving as the point of contact for communication relating to misrepresentation claims.
FinanceFinancial ServicesHealth CareInsurance
Responsibilities
Review, investigate, and maintain internal red flag control reports. Identify, report, and resolve any confirmed instances of misrepresentation
Review and investigate claims for potential misrepresentation that are referred from internal or external sources
Identify trends in red flags and instances of confirmed misrepresentation to enhance our controls
Refer all suspicious claims to SIU for official investigation and review final reports to evaluate for areas of improvement
Maintain reporting and tracking of confirmed falsified claims and any financial losses, to ensure they are identified to all appropriate business partners; ME Authority, Aflac privacy, SIU, Accounting, etc
Serve as the point of contact for incoming and outgoing communication relating to suspicious or confirmed misrep claims
Offer continuous education to case managers to enhance their ability to identify, understand, and investigate potential red flags and instances of misrepresentation
Qualification
Required
Knowledge and skills in Microsoft Office
Knowledge of Aflac/PLADS systems, products and procedures, company terminology
Knowledge of business operations and industry
Excellent oral, written, and interpersonal communication skills to effectively interact with internal and external customers
Ability to maintain professionalism
Ability to successfully work independently or with a team
Excellent attention to detail to ensure accuracy of data
Ability to meet deadlines
High School Diploma or Equivalent
Three years of job related experience
Or an equivalent combination of education and experience
Preferred
Disability and Absence Case Management Experience/Product Knowledge
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
Other leaves of absence
Company
Aflac
Aflac is a company that offers individuals and companies supplemental disability insurance.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
unknown1974-06-14IPO
Leadership Team
JR Shamley
SVP National Accounts Business Development & Growth Solutions
Matthew D. Owenby
SVP, Chief Human Resources Officer and Corporate Services Executive
Recent News
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