Life Benefit Claims Specialist I - Hybrid & Growth

Sun Life; Portland (ME); Hybrid; USD 56,000 - 84,000; Full time

Benefits offered by this job

Hybrid work model

Competitive benefits package

Job summary

Sun Life U.S. is seeking a Life Benefit Case Manager I to conduct reviews, investigations and liability for Group Life Insurance Claims.

This role handles more complex claims under supervision, including High Dollar and Accidental Death investigations, adhering to Sun Life policies. The position supports a hybrid in-office/virtual model, with two days on-site weekly, and offers a discretionary annual incentive.

Qualifications

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

Responsibilities

• 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.

Skills

Claims experience

Analytical skills

Problem solving

Decision making

Team collaboration

Education

High School Diploma

Tools

MS Word

Excel

Email systems

Job description

Sun Life U.S. is seeking a Life Benefit Case Manager I to conduct reviews, investigations and liability for Group Life Insurance Claims.

This role handles more complex claims under supervision, including High Dollar and Accidental Death investigations, adhering to Sun Life policies. The position supports a hybrid in-office/virtual model, with two days on-site weekly, and offers a discretionary annual incentive.