Hybrid Case Manager I - Long-Term Disability

University of Minnesota School of Nursing; Portland (OR); Hybrid; USD 55,000 - 83,000; Full time

Benefits offered by this job

Comprehensive benefits

Paid time off

401(k) retirement plan

Job summary

Sun Life U.S. in the United States is seeking a Case Manager I, LTD to manage a caseload of long term disability claims, applying contractual provisions and medical and occupational records to decide on acceptance or denial and duration of benefits.

This hybrid role combines independent work with team collaboration, clear communication to claimants, and coordination with vocational staff to explore rehabilitation opportunities while ensuring accurate, timely benefit payments.

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

Customer service

Independent & team work

Detailed claimant interviews

Analytical thinking

Negotiation

Court/testimony readiness

Job description

Sun Life U.S. in the United States is seeking a Case Manager I, LTD to manage a caseload of long term disability claims, applying contractual provisions and medical and occupational records to decide on acceptance or denial and duration of benefits.

This hybrid role combines independent work with team collaboration, clear communication to claimants, and coordination with vocational staff to explore rehabilitation opportunities while ensuring accurate, timely benefit payments.