Life Benefit Case Manager I

Sun Life•Nashville, TN

8d•$56,000 - $84,000•Hybrid

About The Position

The Life Benefit Case Manager I reviews, investigates, and determines liability for Group Life Insurance claims. This experienced claims examiner role handles claims beyond the scope of a Life Benefit Specialist, including high-dollar claims, complex benefit calculations, and Accidental Death investigations. Under the direct supervision of the Senior Manager, the Case Manager follows established guidelines to adjudicate claims in accordance with Sun Life-issued Group Life Insurance policies.

Requirements

High school diploma or equivalent.
Strong analytical, critical-thinking, problem-solving, and decision-making skills.

Nice To Haves

At least 2 years of claims experience is preferred.
Effective and professional written and verbal communication skills, with a strong commitment to client service and quality.
Ability to work well independently and in a team environment.
Strong computer skills, including proficiency in a PC environment, MS Word, Excel, and email systems.

Responsibilities

Communicate professionally and compassionately by telephone and in writing with beneficiaries, employers, benefit administrators, and other applicable parties to gather information for eligibility analysis.
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 required.
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 for claim decisions in an online environment.
Escalate issues to management as needed.
Work effectively and independently in a virtual team environment, building relationships with peers and staff from other departments.
Maintain flexibility and an agile mindset in response to change.
Mentor and assist with training less experienced employees.
Take ownership of professional development.
Proactively solve problems and 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 overall business performance.