Senior Consultant , Senior Financial & Subrogation Liaison

Sun Life•Wellesley, CT

5d•Onsite

About The Position

This position will work closely with our subrogation vendor on investigating and pursuing subrogation from appropriate parties for recovery on STD and LTD claims. This includes making decisions about liability/compensability, evaluating losses, and negotiating settlements.

Requirements

Minimum 3 years previous related work experience as well as specific disability product line experience required.
5 years of LTD and STD experience required.
Excellent interpersonal skills to communicate and negotiate with other parties and conduct investigations required.
Proven interpersonal, analytical and negotiation abilities required.
Ability to provide information in a clear, concise manner.
Ability to build effective relationships.
Ability to exercise independent judgment, effectively make sound business decisions, and resolve unique and challenging problems.
Advanced analytical and problem-solving skills.
Ability to multi-task and to independently prioritize competing demands/requests within given time constraints.
Excellent conflict resolution skills.
Familiarity with Claims administration systems.
Proficiency in Microsoft Office suites (Excel, PowerPoint, Word, Outlook).

Nice To Haves

Attains and maintains appropriate TPA licenses in accordance with the Claims Licensing Policy.

Responsibilities

Investigating and pursuing subrogation from appropriate parties for recovery on STD and LTD claims.
Making decisions about liability/compensability.
Evaluating losses.
Negotiating settlements.
Train Claims department including LTD and STD.
Give candid and meaningful feedback to Claims.
Interpret and communicate disability contract language.
Interpret policy language and utilize the parameters to calculate complex subrogation and monthly benefit calculations.
Attain and maintain appropriate TPA licenses in accordance with the Claims Licensing Policy.
Negotiate claims to fairly resolve and reduce liability for Fullscope RMS and Client Carrier Partners.
Proactively handle the claim file through various phases of subrogation.
Review the applicability of coverage and civil law as well as local statutes.
Communicate with various parties associated with the claim.
Respond to written and verbal inquiries in a timely and professional manner, ensuring compliance within all company and statutory guidelines.
Negotiate settlements with insureds and third parties.
Work with and manage costs of outside vendor.
Identify subrogation opportunities and work with vendor to obtain recoveries.
Serve as a subject matter expert to the claims department in all matters associated with third party and subrogation pursuit, including managing workflow, responding to third-party and subrogation vendor needs, as well as training and coaching employees.
Support the development of an organization focused on quality claims management.
Apply technical knowledge to support departmental development, special projects, and programs.
Demonstrate proficient understanding of carrier/clients and accurate application of client specifics in client brand protection by the team.
Identify and communicate developmental areas which need improvement within the analyst’s or client’s block of business.
Provide developmental feedback to team members on case level actions within the context of a training and coaching relationship.
Assist in the design and delivery of training programs.
Complete special projects as necessary.
Maintain an acceptable level of technical acumen, policy and laws.
Deliver dependable, accurate, timely service and build strong relationships with clients and colleagues.
Conduct internal and external claims audits & training seminars.
Participate in the development of internal policies and procedures.
Participate in industry and client meetings as well as client presentations and training.