Claims Specialist

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Position Overview

The position available is for a Claims Specialist at DTLA Benefits, part of the renowned insurance company Aflac. The role is classified as a full-time position that can be performed remotely from anywhere within the continental United States. The job requires the selected candidates to process claims for Wellness, Accident, and Vision insurance, determining their validity based on the documentation provided by policyholders.

Company Background

The employer, DTLA Benefits, operates under Aflac, which is not only a Fortune 500 company but also an industry leader in voluntary insurance products. With a brand that is widely recognized across America, Aflac has gained acknowledgment for its workplace diversity and ethical standards. The company emphasizes a culture of empowerment, community giving, and acknowledging every success along the way, as exemplified by their motto of "The Aflac Way". The employees are often referred to as "the duck," making the workplace feel like a home where careers flourish.

Job Location

The job is located in GA, US, 31999, emphasizing the company's flexibility with remote work, allowing employees to operate from the comfort of their own homes.

Required Skills and Qualifications

To succeed in the role of Claims Specialist, candidates must possess a variety of competencies:

1. Customer Service Skills: Knowledge of principles and processes for providing customer and personal services, including needs assessment and evaluation of customer satisfaction.

2. Administrative Knowledge: Familiarity with administrative and clerical procedures, such as word processing, file management, and office procedures.

3. Communication: Strong skills in listening and understanding others, coupled with the ability to communicate effectively across various channels.

4. Problem-Solving Abilities: Skills in organizing and interpreting new information to solve current and future issues.

5. Mathematical Skills: Proficiency in using mathematics to address and resolve problems.

6. Self-Management: Effective time management skills and a proactive approach when assisting customers.

Roles that require bilingual skills are also encouraged, particularly fluency in Spanish, enabling communication with a broader range of clients.

Educational Requirements

A high school diploma or equivalent is required, along with at least one year of work experience. Familiarity with Microsoft Office Suite is considered essential for performing day-to-day tasks. Preferred qualifications include experience with medical terminology or related educational backgrounds.

Responsibilities

The role involves several key responsibilities, which include:

• Reviewing and processing claims for insurance coverage, adhering to established policies and procedures.
• Determining the nature and validity of claims, requiring scrutiny of policy status and supporting documentation.
• Data entry of claims while interpreting relevant medical coding and term completion.
• Providing customer service regarding claims, including following up on inquiries and verifying the accuracy of submitted information.
• Maintaining various databases and preparing necessary reports and documentation as needed.
• Performing clerical duties such as filing, photocopying, and document management.

Salary and Total Rewards

The salary range for the Claims Specialist position is set between $37,000 and $43,680 annually. This salary range is flexible and takes into account various factors, such as education, experience, geographical location, and peer compensation among others. Aflac emphasizes future growth in salary, typically advocating for employees to receive increases rather than being hired at the top of the pay range.

In addition to the base salary, Aflac offers an extensive benefits package that includes:

• Medical, dental, and vision coverage.
• Prescription drug coverage.
• Flexible spending accounts for health and dependent care.
• Aflac supplemental policies at no cost to employees.
• A 401(k) plan and potential annual bonuses.
• Paid holidays, with employees accruing up to 20 days of paid time off (PTO) per year, alongside any applicable sick leave provisions.

Conclusion

This role should particularly appeal to individuals who value quality customer service, possess the relevant skills outlined, and seek a supportive work environment. The position not only offers financial compensation but also various employee benefits that speak to Aflac's commitment to employee welfare and satisfaction. If you are motivated to help people and contribute to a well-respected company in the insurance sector, applying for this position as a Claims Specialist at DTLA Benefits could be an excellent opportunity.

This job offer was originally published on remoteOK.com