Hybrid LTD Claims Case Manager I

Sun Life; Milwaukee (WI); Hybrid; USD 55,000 - 83,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

Sun Life U.S. is a leading provider of employee and government benefits, offering long term disability claim management and a hybrid work model.

The Case Manager I, LTD role focuses on managing a caseload of disability claims with emphasis on analytical review, documentation, and clear communication with claimants. You will determine acceptance or denial of benefits, coordinate with medical and occupational records, and provide credible written rationales while collaborating with a team.

Qualifications

• Excellent written and verbal communication skills with customer service orientation.
• Must be able 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 skills

Independence

Claimant interviews

Critical thinking

Analytical ability

Job description

Sun Life U.S. is a leading provider of employee and government benefits, offering long term disability claim management and a hybrid work model.

The Case Manager I, LTD role focuses on managing a caseload of disability claims with emphasis on analytical review, documentation, and clear communication with claimants. You will determine acceptance or denial of benefits, coordinate with medical and occupational records, and provide credible written rationales while collaborating with a team.