Life Benefit Case Manager I

Sun Life•Portland, ME

7d•Hybrid

About The Position

The Life Benefit Case Manager I reviews, investigates, and determines liability for Group Life Insurance claims. This claims examiner role handles more complex claims than a Life Benefit Specialist, including high-dollar claims, complex benefit calculations, and accidental death investigations. The position works under the direct supervision of the Senior Manager and follows established guidelines to adjudicate claims in accordance with Sun Life-issued Group Life Insurance policies.

Requirements

High school diploma or equivalent required.
Strong analytical, critical-thinking, problem-solving, and decision-making skills.
Ability to communicate effectively and professionally, both verbally and in writing.
Strong commitment to client service and quality.
Ability to work well independently and in a team environment.
Strong computer skills, including proficiency with a PC environment, MS Word, Excel, and email systems.

Nice To Haves

Minimum 2 years of claims experience preferred.

Responsibilities

Communicate professionally and compassionately by telephone and in writing with beneficiaries, employers, benefit administrators, and other applicable parties to gather information needed to analyze eligibility for life benefits.
Adjudicate claims accurately and fairly in accordance with the policy, claim policies and procedures, and state and federal regulations.
Calculate complex benefit payments accurately, including applicable interest when relevant.
Meet established quality-control measures, individual productivity requirements, and customer-service standards for claim reviews and decisions.
Participate in departmental team meetings and lead Continuous Improvement forums to identify process and efficiency enhancements.
Document claims accurately and provide appropriate analysis of claim decisions in an online environment.
Escalate issues to management as needed.
Work independently and effectively in a virtual team environment, building relationships with peers and staff in other departments.
Remain flexible and maintain an agile mindset as circumstances change.
Mentor and assist with training less experienced employees.
Take ownership of professional development and proactively identify ways to improve personal and team work practices.

Benefits

Generous vacation and sick time.
Paid family, parental, and adoption leave.
Medical coverage.
Company-paid life and AD&D insurance.
Disability programs.
Partially paid sabbatical program.
401(k) employer match.
Stock purchase options.
Employer-funded retirement account.
Flexible, inclusive, and collaborative work environment that supports career growth.
Discretionary annual incentive award based on individual and business performance.