Senior Claims Adjudicator

Sun Life Financial; Southwestern Ontario; Hybrid; CAD 58,000 - 93,000; Full time

Job summary

A leading insurance firm is seeking a Living Benefits Claim Adjudicator in Southwestern Ontario. In this role, you will manage living benefit claims, analyze medical documents, and work collaboratively with clients, advisors, and healthcare professionals. Candidates must be bilingual in French and English and possess excellent communication skills. The position offers a comprehensive benefits package, emphasizing continuous professional development, in a supportive team atmosphere. A unique opportunity to contribute positively to clients' lives while maintaining a balanced work environment.

Benefits

Medical, dental, and life insurance

Paid vacation

Tuition assistance

Comprehensive training programs

Qualifications

• Strong understanding of medical documentation and insurance principles.
• Ability to manage sensitive inquiries with empathy.
• Capability to work collaboratively with various stakeholders.

Responsibilities

• Manage living benefits insurance claims and analyze medical.
• Build strong relationships with advisors to facilitate claim experiences.
• Evaluate entitlement by reviewing medical, contractual, and occupational information.

Skills

Bilingualism (French, English)

Excellent written and verbal communication skills

Extensive knowledge of medical terminology

Experience in handling Critical Illness, Long-Term Care and/or Individual Disability claims

Excellent problem solving and analytical skills

Attention to detail

Team player with a positive attitude

Strong organizational and time-management skills

Strong computer skills

Education

College diploma/university degree/CEGEP degree or relevant experience

Tools

Word

Excel

Job description

Job Description

You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.

Employment type

1-year contract

Are you interested in contributing to the health of Canadians? At Sun Life, we believe in being there when it matters most. If you are interested in delivering on these key moments, are action-oriented and demonstrate empathy, we want you to join our company. Putting the client at the center of everything we do, we will work together to create the moment of truth. Our claim adjudicators can make a difference in our clients’ lives and in return, we actively support their professional development by offering a dynamic workplace, challenging and rewarding work and opportunities to build an exciting career!

As a Living Benefits Claim Adjudicator, you play a crucial role in the lives of our clients and offer them financial reassurance when they most need it. In this role, you will be responsible for case managing living benefit claims to resolution. This includes determining eligibility through to supporting recovery and return to work for approved claims.

What will you do?

• Build strong relationships with our advisors, working in partnership with them to facilitate the claim experience
• Manage living benefits insurance claims and analyze medical
• Assess claims for benefit entitlement by reviewing contractual, medical, functional and occupational information
• Work collaboratively with advisors, clients, health care practitioners and other stakeholders to obtain information, provide claim status, create action plans and provide verbal and written decisions while maintaining confidentiality and privacy
• Demonstrate empathy
• Prioritize work items to meet client service standards and Sun Life best practice guidelines
• Contribute to a dynamic work environment by identifying opportunities to improve processes and client focused delivery
• Communicate clearly and proactively with clients, advisors and various professionals and effectively manage their expectations
• Evaluate opportunities for process improvements and actively participate in team initiatives and projects

Requirements

• Bilingualism (French, English) is required for the frequent interactions with English and French-speaking colleagues or internal partners across Canada
• Excellent written and verbal communication skills with an ability to handle sensitive inquiries
• Extensive knowledge of medical terminology
• Experience in handling Critical Illness, Long-Term Care and/or Individual Disability claims
• Excellent problem solving and analytical skills
• Attention to detail
• Team player with a positive attitude and commitment to provide outstanding quality service
• Strong organizational and time-management skills
• Strong computer skills with knowledge of Word and Excel
• College diploma/university degree/CEGEP degree or relevant experience

Assets

• Education involving knowledge of the anatomy (e.g. nursing, kinesiology, etc.)
• Individual insurance product knowledge
• LOMA courses and FLHC designation or dedication to work towards attaining it

What Sets Us Apart?

• Our commitment to service excellence and quality, innovation and talent development
• Career progression is based on solid performance, knowledge of our business and products, positive engagement with our clients, and your interests opening up a wide variety of career paths within Sun Life
• Ability to work in a dynamic, collaborative environment where you are encouraged to share your ideas
• Comprehensive benefits package including:
  • Medical, dental, and life insurance
  • Paid vacation
  • Tuition assistance
• A supportive and interactive team environment
• Comprehensive training programs from the start of employment and ongoing coaching to set you up for success

#LI-Hybrid

The Base Pay range is for the primary location for which the job is posted. It may vary depending on the work location of the successful candidate or other factors. In addition to Base Pay, eligible Sun Life employees participate in various incentive plans, payment under which is discretionary and subject to individual and company performance. Certain sales focused roles have sales incentive plans based on individual or group sales results.

Diversity and inclusion have always been at the core of our values at Sun Life. A diverse workforce with wide perspectives and creative ideas benefits our Clients, the communities where we operate and all of us as colleagues. We welcome applications from qualified individuals from all backgrounds.

Persons with disabilities who need accommodation in the application process, or those needing job postings in an alternative format, may e‑mail a request to [e-mail].

We are proud to be a hybrid organization that offers our employees the choice and flexibility to work from both the office and virtually based on the needs of the business, our Clients and you! Several work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.

We may use artificial intelligence to support candidate sourcing, screening, interview scheduling.

We thank all applicants for showing an interest in this position. Only those selected for an interview will be contacted.

Salary Range:

58,000/58 000 - 93,000/93 000

Job Category:

Claims - Life & Disability

Posting End Date:

21/01/2026