Disability Claims Case Manager I

Palo Verde Community College District; Hartford (CT); Hybrid; USD 55,000 - 83,000; Full time

Benefits offered by this job

Comprehensive benefits

Generous leave

401(k) match

Job summary

Sun Life U.S. is seeking a Case Manager I, LTD to manage a caseload of long-term disability claims, applying contractual provisions and reviewing medical and occupational records.

The role supports Sun Life's hybrid work model, balancing in-office collaboration with virtual work and requiring presence at least 2 days per week. You will communicate decisions clearly and confidently, work independently and with teams, and participate in claims payment processing, while evaluating rehabilitation

Qualifications

• Excellent written and verbal communication skills with customer service orientation.
• Must be able to work independently and a team environment.
• Ability to conduct detailed claimant interviews.
• Solid critical thinking skills as well as the ability to negotiate with people.
• Demonstrated expert analytical skills with the ability to think creatively and address the strengths and weaknesses of a claim and the fine distinctions in contract language.

Responsibilities

• Manage and prioritize a group of claims on an ongoing basis while maintaining appropriate documentation
• Obtain all pertinent and necessary information to evaluate claim credibility
• Prepare written rationale of claim decision based on review of contractual provisions and analysis of medical and occupational records
• Process claims for payment by setting up on claim paying system to ensure accurate and timely receipt of payment benefits
• Assess vocational rehabilitation opportunities by working with vocational staff
• Use investigative tools, may testify in court cases and provide depositions related to claim disputes based on technical expertise

Skills

Communication skills

Independent work

Interviewing

Critical thinking

Contract language analysis

Job description

Sun Life U.S. is seeking a Case Manager I, LTD to manage a caseload of long-term disability claims, applying contractual provisions and reviewing medical and occupational records.

The role supports Sun Life's hybrid work model, balancing in-office collaboration with virtual work and requiring presence at least 2 days per week. You will communicate decisions clearly and confidently, work independently and with teams, and participate in claims payment processing, while evaluating rehabilitation