Senior Consultant , LTD Claims Investigation Services

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.

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 Senior Consultant I, LTD Claims Investigation Services assists in obtaining information that may be relevant to the claims investigation and adjudication process. Senior Consultants (CIS) assist Case Managers to complete investigations that reflect strong claims fundamentals.

If you have the desire to assist in technology driven public information searches and activities investigations, to liaison with Compliance when misrepresentation is expected, and to collaborate with claims colleagues regarding case management strategies - this could be the role for you. We are looking for a candidate with a high level of energy who will leverage their claims management experience and analytical skills in a collaborative team environment.

• Audit files with the ability to handle multiple priorities simultaneously to prevent, detect and mitigate suspicious activity.
• Triage files with case managers, clinical and vocational staff.
• Coordinate background checks and surveillance with vendors.
• 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.
• Use investigative tools, may testify in court cases and provide depositions related to claim disputes based on technical expertise

• Ability to work with a diverse range of people
• 3+years' experience managing Group Disability Claims, strongly preferred.
• 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

• Excellent written and verbal communication skills with client 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

$72,500 - $108,800

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…