Life Benefit Case Manager I

Sun Life Assurance Company of Canada; Portland (ME); Hybride; USD 56 000 - 84 000; Plein temps

Avantages offerts par ce poste

Hybrid work model

Résumé du poste

Sun Life U.S. is seeking a Life Benefit Case Manager I to conduct reviews, investigations, and liability assessments for Group Life Insurance Claims. The role handles complex claims under supervision, with a focus on accurate adjudication and continuous improvement.

Hybrid work model requires in-office presence at least 2 days per week. Strong analytical, communication and mentorship abilities are valued as you support teammates and clients nationwide.

Qualifications

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

Responsabilités

• Communicates with professionalism and compassion via telephone and written contact to gather data and analyze eligibility.
• Adjudicates claims accurately and fairly in accordance with policy and regulations.
• Calculates complex benefit payments with accuracy.
• Meets established quality, productivity and customer service standards.
• Mentors and assists with training of less experienced employees.
• Proactively problem solves and identifies ways to improve work practices.

Connaissances

Analytical skills

Problem solving

Communication

Teamwork

Formation

High School Diploma or equivalent

Outils

MS Word

Excel

Description du poste

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.

At Sun Life, we're driven by our Purpose: helping our Clients achieve lifetime financial security and live healthier lives. Our values shape how we work: caring, authentic, bold, inspiring, and impactful.

When you join Sun Life, you'll work with passionate colleagues and empowering leaders who support your growth and celebrate your contributions, so you can make a meaningful difference in our Clients' lives.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.

Job Description:

Location:

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. Our team members and leaders are expected to foster connection and teamwork by being present in the office at least 2 days per week.

The opportunity:

The Life Benefit Case Manager I conducts the reviews, investigation and liability of Group Life Insurance Claims. The Life Benefit Case Manager I is a claims examiner experienced role that requires skills to process more complex claims beyond a Life Benefit Specialist, such as High Dollar, Complex Benefit Calculations and Accidental Death investigations. The Life Benefit Case Manager I works under direct supervision of the Senior Manager, following established guidelines to ensure claims are adjudicated in accordance with Sun Life Issued Group Life Insurance policies.

How you will contribute:

• Communicates with professionalism and compassion using telephone and written contact with the applicable parties (i.e., beneficiary, employer/benefit administrator) 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.

What you will bring with you:

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

Preferred skills (heading) / Compétences particulières (titre )

• Communicates effectively and professionally with others, written and verbally. Strong commitment to client service and quality
• Ability to work well independently and in a team environment
• Strong computer skills, proficient in a PC environment and MS Word, Excel, and email systems

Salary:

$56,000 - 84,000

At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.

We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.

Life is bright