Overpayment Recovery Analyst

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.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.

At Sun Life, we look for optimistic people who want to make life brighter for our Clients. We understand the value of diverse cultures, perspectives, and identities, and want you to bring your full and authentic self to work. Every day, you'll be empowered and challenged by working with dynamic colleagues to find new and innovative ways to make Sun Life the best benefits company in America.

Sun Life embraces a hybrid work model that balances in‑office collaboration with the flexibility of virtual work. Internal candidates are not required to relocate near an office.

The Health and Risk Solutions Overpayment Recovery Analyst is primarily responsible for conducting reconciliations for individual stop loss claim reimbursements. Additional responsibilities include handling escheatment, offsets within the claims system, and various special projects.

• Track, calculate and pursue over payments identified within the Stop Loss department. This includes researching files, having a full understanding of claims, types of over payment, over payment resolution options, and total knowledge of systems used by the claims department.
• Follow up on over payment requests, which may include discussions with Administrators, Claim Analysts, Brokers—both internal and external customers—via conversation and/or letters, and provide detailed descriptions of circumstances around over payment.
• Provide monthly current recovery reports (analysis, trending, actions, status), contacting external customers (Administrator, Broker, outside collection agency).
• Receive escheatment report, investigate customer data, and provide data to banking for potential stop pay/re‑issue of checks.

• Ability to work with a diverse range of people.
• Expert‑level understanding of the Stop Loss claims process or Medical Claims with respect to how over payments are determined, processes for write‑offs, and succinct, detailed communication to external customers requesting monies.
• 5+ years of experience understanding first‑dollar Stop Loss claims or medical claims, and prior experience in medical or Stop Loss claim adjudication.
• Proficient in Excel with advanced skills, including complex formula construction, pivot table manipulation, VLOOKUP, and queries.
• Adept knowledge in navigating and utilizing SharePoint features at an intermediate level, including document management, tracker creation, and basic site administration.
• Strong understanding of business and relationship building with external customers.
• Highly skilled verbal and written communication skills.

• Excellent benefits and wellness programs to support the three pillars of your well‑being—mental, physical, and financial—including generous vacation and sick time, market‑leading paid family, parental and adoption leave, a partially‑paid sabbatical program, medical plans, company‑paid life and AD&D insurance, disability programs, and more.
• Retirement and Stock Purchase programs to help build and enhance your future financial security, including a 401(k) plan with an employer‑paid match and an employer‑funded retirement account.
• A flexible work environment with a friendly, caring, collaborative and inclusive culture.
• Great Place to Work Certified in Canada and the U.S.
• Named as a “Top 10” employer by the Boston Globe’s “Top Places to Work” two years running.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender…