Hybrid LTD Claims Specialist

University of Minnesota School of Nursing; Milwaukee, Northern (WI, KY); Hybrid; USD 55,000 - 83,000; Full time

Benefits offered by this job

Generous vacation and sick time

Market-leading family leave

Accommodations in benefits

Job summary

Sun Life U.S. seeks a Case Manager I, LTD to manage a caseload of long-term disability claims, applying contractual provisions and medical records to decide on acceptance/denial and payment duration. You will communicate findings clearly and sensitively to claimants.

Responsibilities include prioritizing claims, gathering information, and coordinating with vocational staff to explore rehabilitation opportunities. Strong analytical and communication skills are essential.

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.
• Demonstrated expert analytical skills to evaluate claims.

Responsibilities

• Manage and prioritize a group of claims with proper documentation.
• Obtain all pertinent information to evaluate claim credibility.
• Prepare written rationale based on contract provisions and medical/occupational records.
• Process claims for payment and ensure timely payments.
• Assess vocational rehabilitation opportunities with vocational staff.
• May testify in court cases and provide depositions related to disputes.

Skills

Excellent written/verbal communication

Independent and team work

Detailed claimant interviews

Critical thinking & negotiation

Analytical skills

Job description

Sun Life U.S. seeks a Case Manager I, LTD to manage a caseload of long-term disability claims, applying contractual provisions and medical records to decide on acceptance/denial and payment duration. You will communicate findings clearly and sensitively to claimants.

Responsibilities include prioritizing claims, gathering information, and coordinating with vocational staff to explore rehabilitation opportunities. Strong analytical and communication skills are essential.