Hybrid Long-Term Disability 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, applying contract provisions and medical records to decide on acceptance or denial and benefit duration.

This role supports independent work within a collaborative team, with a hybrid model requiring in-office presence at least 2 days per week and a focus on timely, accurate payments and clear claimant communications.

Qualifications

• Excellent written and verbal communication with customer service orientation.
• Ability to work independently and in a team.
• Ability to conduct detailed claimant interviews.
• Strong critical thinking and negotiation skills.
• Analytical skills to interpret contracts and medical records.

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 skills

Independent worker

Claimant interviews

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, applying contract provisions and medical records to decide on acceptance or denial and benefit duration.

This role supports independent work within a collaborative team, with a hybrid model requiring in-office presence at least 2 days per week and a focus on timely, accurate payments and clear claimant communications.