Job Description

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. As a Benefit Analyst, Life Waiver of Premium, 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 life waiver claims. Leverage your analytical and communication skills to work independently while also thriving in a team setting. This role is key to Sun Life’s journey of building the best company in America. This role requires applying the appropriate policy provisions and department procedures to the medical and occupational facets of each claim to determine if the claim can be approved. This is accomplished by using an inter-disciplinary approach to make accurate claim decisions. Communication skills are needed to explain the decisions and to facilitate optimal outcomes. The Benefit Analyst, Life Waiver of Premium is accountable for developing, coordinating, and implementing a plan of action for each claim to ensure it is managed effectively for the duration of the disability. Conduct initial claim eligibility review. Obtain all pertinent and necessary information to evaluate claims. Confirm that medical evidence supports claimant's restrictions & limitations. Prepare written rationale of claim decision based on a review of the contractual provisions and the analysis of the medical and occupational records. Process claims for payment. Develop and document claim strategy for ongoing claim management. Prioritize caseload and work; maintain appropriate documentation. Assess occupational job duties and rehabilitation opportunities by working with vocational staff. Appropriately use investigative tools; may testify in court cases, respond to State Insurance Department complaints/requests, and provide depositions related to claim disputes based upon technical expertise. Ability to work with a diverse group of people. Bachelor’s degree is preferred. Claims experience with knowledge of disability/life claim management practices is a plus. Strong computer and technical skills. Exceptional customer service skills. Strong mathematical skills for calculation of claim payments. Excellent organizational skills and an effective ability to multi-task. Solid judgment and discretion with exposure to confidential information. Analytical and problem-solving skills. Ability to work autonomously and in a team environment. Excellent written and verbal communication skills. Strong interpersonal skills. Demonstrated ability to meet deadlines with a high level of accuracy and attention to detail.

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