Overpayment Recovery Analyst

Introduction

Sun Life U.S. is one of the largest providers of employee and government benefits, serving approximately 50 million Americans. We offer a broad portfolio of benefits including dental, vision, disability, absence management, life, supplemental health, medical stop‑loss insurance, and healthcare navigation.

Health and Risk Solutions Overpayment Recovery Analyst is responsible for reconciling individual stop‑loss claim reimbursements, handling escheatment and offsets, and leading special projects.

• Track, calculate, and pursue over payments identified within the Stop Loss department, including research of files and full understanding of claim types and over payment resolution options.
• Follow up on over payment requests, discussing details with administrators, claim analysts, brokers, and external customers via conversation or written communication.
• Provide monthly recovery reports with analysis, trending and status updates; contact external customers such as administrators and brokers.
• Receive escheatment reports, investigate customer data, and provide information to banking for potential stop‑pay or re‑issue of checks.

• 5+ years of experience in first‑dollar stop‑loss or medical claim adjudication.
• Expert knowledge of the stop‑loss claims process and over payment determination, including write‑offs.
• Advanced Excel skills: complex formulas, pivot tables, VLOOKUP, and queries.
• Intermediate proficiency in SharePoint (document management, tracker creation, basic site administration).
• Strong communication skills—verbal and written—capable of building relationships with external customers.

• Generous vacation and sick time, market‑leading paid family, parental and adoption leave, and a partially‑paid sabbatical program.
• Medical plans, company‑paid life and AD&D insurance, and comprehensive disability programs.
• Retirement and stock purchase options with a 401(k) plan and employer match.
• Flexible work environment and inclusive, collaborative culture.
• Recognized as a Great Place to Work® Certified in Canada and the U.S., and named a Top 10 employer by the Boston Globe.

Salary Range: $68,200 – $102,300. The base salary will be determined based on skills, experience, education, and location. This role is eligible for a discretionary annual incentive award.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Job Category:
Claims – Health & Dental

Posting End Date: 01/05/2026