Claims Technical Lead

This is a fully remote position, open to applicants in United States.

📋 Description

• Serves as the primary contact for case managers regarding claims-related inquiries.

• Acts as a mentor for new team members and assists in the training of new hires.

• Actively participates in refresher training and the professional development of current staff.

• Ensures case managers apply the necessary risk management skills to achieve optimal claim outcomes.

• Conducts necessary reviews and audits of claims to uphold quality standards.

• Provides timely coaching and feedback to case managers as required.

• Monitors key performance indicators and reports to ensure service levels and commitments are fulfilled, collaborating with case managers when needed.

• Oversees and adjusts the workload distribution among case managers.

• Aids management in organizing team meetings and huddles.

• May occasionally handle complex cases and customer escalations.

• Identifies and communicates trends and coaching opportunities to the leadership team.

• Completes special projects and/or ad hoc assignments as directed by leadership.

• Performs other related responsibilities as necessary.

⛳️ Requirements

• Bachelor's Degree in business, management, or a related discipline.

• A minimum of 4 years of relevant work experience.

• At least 2 years of experience in STD/LTD case management.

• Exceptional critical thinking and decision-making abilities.

• Strong leadership and organizational capabilities.

• Comprehensive understanding of contracts, plans, and products.

• In-depth knowledge of best practices and effective case management techniques.

🏝️ Benefits

• Medical, dental, and vision insurance.

• Coverage for prescription medications.

• Flexible spending accounts for healthcare expenses.

• Flexible spending accounts for dependent care.

• Aflac supplemental policies (Accident, Cancer, Critical Illness, and Hospital Indemnity provided at no cost to employees).

• 401(k) retirement plans.

• Annual bonus opportunities.

• Option to purchase company stock.

• 11 paid holidays.

• Up to 20 days of paid time off (PTO) available for any purpose.

• State-mandated sick leave (Washington employees earn 1 hour of sick leave for every 40 hours worked) and additional leaves of absence.