Senior Manager, Claims

Sun LifeWellesley, MA
Hybrid

About The Position

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. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities. Job Description: Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. Our team members and leaders are expected to foster connection and teamwork by being present in the office at least 2 days per week. The Opportunity The Senior Manager, Life & Disability Claims is part of the Claims Management Team and is responsible for the successful management of the day-to-day operations of our Long Term Disability claims team, as well as fostering client relations and ensuring the accurate risk management of disability claims.

Requirements

  • Ability to work with a diverse group of people
  • Technically proficient in disability products and claims, with a minimum of 5 years progressively responsible disability claims experience
  • Attains and maintains appropriate TPA licenses in accordance with the Claims Licensing Policy
  • Demonstrated leadership qualities, prior management experience a plus
  • Proven ability to train and motivate employees
  • Demonstrated ability and willingness to give candid and meaningful feedback
  • Expert technical ability in interpreting and communicating disability policy/contract language
  • Exposure to multiple and complex disability claims issues with demonstrated experience in generating, selecting and implementing solutions to resolve those issues
  • Knowledge of Federal, State and local regulations relating to disability
  • Excellent analytical, critical thinking, problem solving and decision-making skills
  • Excellent verbal communication skills, with the ability to be both pleasant and professional
  • Ability to represent FullscopeRMS and clients effectively
  • Strong written communication skills
  • Solid mathematical skills
  • Strong interpersonal and customer service skills
  • Ability to be flexible and open minded to change and new ideas
  • Confidentiality, discretion and tact are paramount
  • Solid negotiation skills
  • Ability to manage conflict comfortably and effectively
  • Small and large group presentation skills
  • Ability to work in a self-directed manner, and initiating and prioritizing regular work duties and projects
  • Detail oriented, organized, the ability to multi-task, and strong time management skills with the ability to meet deadlines and respond to unexpected requests in a prompt manner
  • Strong computer skills, proficient in PC environment and MS Word, Excel, and email systems
  • Ability to work professionally and effectively with co-workers, clients, claimants, vendors and others with whom FullscopeRMS does business

Responsibilities

  • Leads, manages, hires, trains, retains and motivates a team of claims professionals capable of and committed to providing exceptional service to clients, claimants and internal DRMS partners
  • Ensures the team operation is efficient, effective and in compliance with all federal and state requirements
  • Evaluates the team plan for continual improvement of the efficiency and effectiveness of the group and provides individuals with professional and personal growth- Develops and fosters excellent relationships with clients
  • Collaborate with internal and external partners regarding the profitability of clients’ blocks of business
  • Ensures client complaints/issues are addressed promptly and in accordance with service standards
  • Utilizes operational metrics and reports to track trends and results and adjusts tactics accordingly
  • Participates in the development and communication of internal policies, procedures and systems
  • Supports technological initiatives for the enhancement and efficiency of the claims management process
  • Supports and executes claim management initiatives
  • Conducts internal and external training sessions
  • Conducts internal and external claim audits- Participates in new client prospecting and implementation
  • Completes continuing education requirements to maintain license
  • Participates in industry meetings
  • Participates in product development and product enhancement- Other duties and responsibilities as assigned

Benefits

  • generous vacation and sick time
  • market-leading paid family, parental and adoption leave
  • medical coverage
  • company paid life and AD&D insurance
  • disability programs and a partially paid sabbatical program
  • 401(k) employer match
  • stock purchase options and an employer-funded retirement account
  • flexible, inclusive and collaborative work environment that supports career growth
© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service