Hybrid Disability Claims Case Manager I

Sun Life; Portland (ME); Hybrid; USD 55,000 - 83,000; Full time

Job summary

Sun Life U.S. is seeking a Case Manager I, LTD to manage a caseload of long term disability claims and apply contractual provisions and guidelines to decisions on acceptance or denial.

You will communicate rationale clearly to claimants, while handling payment processes and associated financial risk in a hybrid role. The position emphasizes independent work with collaboration in a team, leveraging analytical and communication skills to deliver timely, accurate decisions in a supportive,

Qualifications

• Excellent written and verbal communication skills with customer service orientation.
• Ability 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 ability to assess contract language.

Responsibilities

• Manage and prioritize a group of claims on an ongoing basis while maintaining documentation.
• Obtain all pertinent information to evaluate claim credibility.
• Prepare written rationale of claim decisions based on contract provisions and medical/occupational records.
• Process claims for payment by setting up on claim paying system to ensure timely receipt of 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.

Skills

Communication

Independent work

Interviewing

Critical thinking

Negotiation

Analytical skills

Job description

Sun Life U.S. is seeking a Case Manager I, LTD to manage a caseload of long term disability claims and apply contractual provisions and guidelines to decisions on acceptance or denial.

You will communicate rationale clearly to claimants, while handling payment processes and associated financial risk in a hybrid role. The position emphasizes independent work with collaboration in a team, leveraging analytical and communication skills to deliver timely, accurate decisions in a supportive,