Operations Analyst

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.  

Location: 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.

How you will contribute:  

• Ensuring the new and renewal contracts match what has been approved by underwriting and the TPA Work Arounds (Specific, Aggregate and Health Navigator (if sold) dates, claim basis, rates, # of lives, Certain Fees, Address, Monthly Accommodation, Terminal Liability, Lasers, Retirees, Transplant Vendor Endorsement, and the Brokers, GA, TPA are all correct.

• Customizing Contract according to TPA Work Arounds and what was sold (ex: If more than one account then sub accounts must be customized – Different Claim Basis, rates, names)

• Setting up the claims system, CMS to make sure all the information is correct, for example (Deductibles, claim basis, Certain Fees, Lasers, Retirees (covered or not), and then enter all contacts for policy and Payee and Banking information.  In addition-Setting up Compass for billing to be sent out to the group.

• Check the claim system CMS (verifying all the information is correct (Deductibles, claim basis, Certain Fees, Lasers, Retirees (covered or not), making sure the Payee and Banking information is correct and checking contacts to make sure they are up to date. 

• Review the previous year’s contract to look for rate tier changes (ex: 2 Tiers to 4 Tiers)

• If rate tiers change or Health Navigator has been added then that information needs to be updated in compass.   

• Administer revisions to contracts when notified by underwriting 

• Other duties as assigned

What you will bring with you:  

• Bachelor’s degree or equivalent work experience

• 2-3 years of experience in the financial services industry

• 2  years of experience working in Stop Loss claims and/or Stop Loss underwriting, preferred

• Ability to comprehend and interpret client plan documents as well as Stop Loss policies, preferred

• Broad knowledge of Stop Loss Insurance products and processes, preferred

• Ability to think creatively to resolve the more complex or non-routine issues

• Strong written and verbal communication skills and experience

• Ability to effectively coach, develop and motivate team member to achieve Department and SLF goals

• Strong negotiation, drawing conclusions and problem solving skills and experience 

• Ability to develop and maintain effective, professional business relationships across all levels of the organization and external TPA administrators and customers

• Accountable for contributing to a workplace environment that fosters mutual respect, cooperation, information sharing and commitment to delivering the expected service and financial results

• Strong PC Proficiency

• Ability to successfully meet deadlines and achieve goals

• Knowledge of company computer systems and products a strong plus

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Salary:  

$49,200 - 66,400
At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions. 

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We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive.  We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate.  We encourage applications from qualified individuals from all backgrounds.

Life is brighter when you work at Sun Life

At Sun Life, we prioritize your well-being with comprehensive benefits, including 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.  Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account.  Enjoy a flexible, inclusive and collaborative work environment that supports career growth.  We’re proud to be recognized in our communities as a top employer.  Proudly Great Place to Work® Certified in Canada and the U.S., we’ve also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row.  Visit our website to learn more about our benefits and recognition within our communities.

We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email [email protected] to request an accommodation.

For applicants residing in California, please read our employee California Privacy Policy and Notice.

We do not require or administer lie detector tests as a condition of employment or continued employment.

Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.