Claims Specialist

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Claims Specialist

The Company: false

The Location:

GA, US, 31999

The Division

Job Id: 9411

Salary Range: $37,000-$43,680

Job Posting End Date: June 29, 2026

We’ve Got You Under Our Wing

We are the duck. We develop and empower our people, cultivate relationships, give back to our community, and celebrate every success along the way. We do it all…The Aflac Way.

Aflac, a Fortune 500 company, is an industry leader in voluntary insurance products that pay cash directly to policyholders and one of America's best-known brands. Aflac has been recognized as Fortune’s 50 Best Workplaces for Diversity and as one of World’s Most Ethical Companies by Ethisphere.com.

Our business is about being there for people in need. So, ask yourself, are you the duck? If so, there’s a home, and a flourishing career for you at Aflac.

Worker Designation – This role is a remote role. This means you will be expected to work from your home, within the continental US. If the role is remote, there may be occasions that you are requested to come to the office based on business need. Any requests to come to the office would be communicated with you in advance.

What does it take to be successful at Aflac?

• Acting with Integrity
• Communicating Effectively
• Pursuing Self-Development
• Serving Customers
• Supporting Change
• Supporting Organizational Goals
• Working with Diverse Populations
  
  

What does it take to be successful in this role?

• Knowledge of principles and processes for providing customer and personal services; this includes needs assessment, meeting quality standards for services, and evaluation of customer satisfaction
• Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, and other office procedures and terminology
• Skill in giving full attention to what other people are saying, taking time to understand the points being made; asking questions as appropriate
• Skill in understanding the implications of new information for both current and future problem solving and decision-making
• Skill in using mathematics to solve problems
• Skill in selecting and using training/instructional methods and procedures when learning new policies, procedures, concepts, or products
• Skill in managing one’s own time and actively looking for ways to help people
• Positions requiring the use of bilingual skills (if applicable to this position): Fluency in Spanish with the ability to translate documents
  
  

Education & Experience Required

• High School Diploma or Equivalent
• 1 year of work experience
• Experience and proficiency using Microsoft Office Suite software
  
  

Education & Experience Preferred

• Experience with medical terminology
  
  

Or an equivalent combination of education and experience

Principal Duties & Responsibilities

• Under immediate supervision and in accordance with established policies and procedures, reviews and processes Wellness, Accident and Vision 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