Hybrid Life Benefit Claims Examiner I

Sunlife; Baltimore (MD); Hybride; USD 56 000 - 84 000; Plein temps

Résumé du poste

Sun Life U.S. is hiring a Life Benefit Case Manager I to conduct reviews, investigations, and liability for Group Life Insurance Claims.

This role handles complex claims beyond a Life Benefit Specialist, including high-dollar and Accidental Death cases, under supervision to ensure policy compliance. The position requires strong analytical and communication skills, a team-oriented yet independent virtual work style, and the ability to mentor junior staff.

Qualifications

• Minimum 2 years of claims experience preferred.
• High School Diploma or equivalent required.
• Strong analytical, critical thinking, problem solving and decision-making skills.

Responsabilités

• Communicates with professionalism and compassion using telephone and written contact with the applicable parties to gather pertinent data to analyze eligibility for the Life Benefit
• Adjudicates claims accurately and fairly in accordance with the policy, appropriate claim policies and procedures as well as state and federal regulations
• Calculates complex benefit payments, which may include applicable interest payable, with accuracy
• Meets established quality control measures, individual productivity requirements as well as customer service standards for claim reviews and decisions.
• Engages in departmental team meetings and leads Continuous Improvement forums to identify process and efficiency enhancements
• Ability to accurately document and provide proper analysis to claim decisions in an on-line environment
• Escalates issues to management as needed
• Works effectively and independently in a virtual team environment, building relationships with peers as well as with staff from other departments.
• Maintains flexibility with change and agile mindset
• Mentors and assist with training of less experienced employees.
• Shows ownership in professional development.
• Proactively problem solves and regularly identifies ways to improve their own work practices, and those of others.

Connaissances

Analytical skills

Critical thinking

Problem solving

Decision making

Communication skills

Formation

High School Diploma

Outils

MS Word

Excel

Email systems

Description du poste

Sun Life U.S. is hiring a Life Benefit Case Manager I to conduct reviews, investigations, and liability for Group Life Insurance Claims.

This role handles complex claims beyond a Life Benefit Specialist, including high-dollar and Accidental Death cases, under supervision to ensure policy compliance. The position requires strong analytical and communication skills, a team-oriented yet independent virtual work style, and the ability to mentor junior staff.