Overpayment Recovery Analyst

About Sun Life U.S.

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 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, researching files and fully understanding claim types, over payment resolution options, and systems used by the claims department.
• Follow up on over payment requests, including discussions with Administrators, Claim Analysts, and Brokers, both internal and external customers, via conversation and/or letters, and provide detailed descriptions of circumstances and specific claim file details.
• Provide monthly current recovery reports (analysis, trending, actions, status) and contact external customers (Administrators, Brokers, outside collection agencies).
• Receive escheatment reports, 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 with first‑dollar stop‑loss claims or medical claims, prior experience in medical or Stop Loss claim adjudication.
• Proficient in Excel with advanced skills, including complex formula construction, pivot table manipulation, VLOOKUP, and query creation.
• Knowledge of SharePoint 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 mental, physical and financial well‑being, 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, 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 a “Top 10” employer by the Boston Globe’s “Top Places to Work” for two years running.

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.

$68,200 - $102,300

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…