Life Benefit Claims Specialist I: Complex Claims Expert

Sun Life; Milwaukee (WI); Hybride; USD 56 000 - 84 000; Plein temps

Résumé du poste

Sun Life U.S. is a leading provider of employee and government benefits, with a hybrid work model and a focus on compassionate service. The Life Benefit Case Manager I reviews complex group life claims, conducts investigations, and adjudicates eligibility under Sun Life policies.

Role requires handling high-dollar and complex calculations, under supervision, with opportunities for mentorship and professional growth in a collaborative virtual environment.

Qualifications

• Minimum 2 years of claims experience preferred.
• Strong analytical, critical thinking, problem solving and decision-making skills.
• Excellent communication with beneficiaries, employers and admins.

Responsabilités

• Communicates with professionalism and compassion to gather data for eligibility analysis.
• Adjudicates claims accurately according to policy and regulations.
• Calculates complex benefit payments, including applicable interest, with accuracy.
• Meets quality, productivity and customer service standards for claim reviews and decisions.
• Participates in team meetings and Continuous Improvement forums to drive efficiencies.
• Documents claim decisions clearly in the online system.
• Works effectively in a virtual team environment and collaborates with other departments.
• Mentors and assists with training of less experienced staff.

Connaissances

Claims experience

Analytical skills

Communication

Team collaboration

Formation

High School Diploma or equivalent

Outils

MS Word

Excel

Email systems

Description du poste

Sun Life U.S. is a leading provider of employee and government benefits, with a hybrid work model and a focus on compassionate service. The Life Benefit Case Manager I reviews complex group life claims, conducts investigations, and adjudicates eligibility under Sun Life policies.

Role requires handling high-dollar and complex calculations, under supervision, with opportunities for mentorship and professional growth in a collaborative virtual environment.