Hybrid Case Manager I, Long-Term Disability

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

Job summary

Sun Life U.S. embraces a hybrid work model balancing in-office collaboration with virtual work.

The Case Manager I, LTD leads a caseload of long-term disability claims, applying contractual provisions and medical data to decisions on acceptance, denial, and duration of benefits. You will communicate rationale clearly and sensitively, manage payment processes, and assess vocational rehab opportunities while working independently within a team.

Qualifications

• Excellent written and verbal communication skills with customer service orientation.
• Must be able to work independently and in a team environment.
• Ability to conduct detailed claimant interviews.
• Solid critical thinking skills and the ability to negotiate with people.
• Demonstrated expert analytical skills with contract language considerations.

Responsibilities

• Manage and prioritize a group of claims on an ongoing basis with proper documentation.
• Obtain all pertinent information to evaluate claim credibility.
• Prepare written rationale of claim decisions based on contractual provisions and medical/occupational records.
• Process claims for payment by setting up on the claims paying system for timely payments.
• Assess vocational rehabilitation opportunities by working with vocational staff.
• Use investigative tools and may testify in court cases or depositions related to claim disputes.

Skills

Communication

Independent work

Teamwork

Interviews

Analytical thinking

Negotiation

Job description

Sun Life U.S. embraces a hybrid work model balancing in-office collaboration with virtual work.

The Case Manager I, LTD leads a caseload of long-term disability claims, applying contractual provisions and medical data to decisions on acceptance, denial, and duration of benefits. You will communicate rationale clearly and sensitively, manage payment processes, and assess vocational rehab opportunities while working independently within a team.