Hybrid Disability Claims Case Manager I

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

Benefits offered by this job

Vacation and sick time

Paid family leave

Medical coverage

Life and AD&D insurance

Disability programs

401(k) employer match

Stock purchase options

Employer-funded retirement account

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 guidelines to determine claim acceptance and benefit duration.

This hybrid role balances in-office collaboration with flexible virtual work, requiring presence in the office at least 2 days per week. You will communicate decisions clearly with claimants and collaborate with vocational staff.

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 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

Independent work

Team collaboration

Claimant interviewing

Critical thinking

Analytical skills

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 guidelines to determine claim acceptance and benefit duration.

This hybrid role balances in-office collaboration with flexible virtual work, requiring presence in the office at least 2 days per week. You will communicate decisions clearly with claimants and collaborate with vocational staff.