Case Manager I LTD

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.

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.

In the role of Case Manager I, LTD you will have the opportunity to make a difference in the lives of individuals who have experienced a disability by successfully managing a caseload of long term disability claims. Leverage your analytical and communication skills to work independently while also thriving in a team setting. This role is key in Sun Life's journey of building the best benefits company in America.

You will manage customer service, the benefit payment process and the financial risk associated with an assigned block of Long Term Disability claims. The Case Manager will apply the appropriate contractual provisions, legal guidelines, claims procedures and protocols to the facts of each claim to decide on its acceptance or denial and the duration of the benefit payment. You will be responsible for clearly communicating the rationale with confidence and sensitivity for the claimant's circumstances.

• 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

• 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

Salary Range: $55,300 - $83,000

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.

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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 brighter when you work at Sun Life

At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth.

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