Senior Consultant I, LTD Claims Investigation Services

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.

At Sun Life, we're driven by our Purpose: helping our Clients achieve lifetime financial security and live healthier lives. Our values shape how we work: caring, authentic, bold, inspiring, and impactful.

When you join Sun Life, you'll work with passionate colleagues and empowering leaders who support your growth and celebrate your contributions, so you can make a meaningful difference in our Clients' lives.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.  

The Opportunity

The Senior Consultant I, LTD Claims Investigation Services assists in obtaining information that may be relevant to the claims investigation and adjudication process.  Senior Consultants (CIS) assist Case Managers to complete investigations that reflect strong claims fundamentals. If you have the desire to assist in technology driven public information searches and activities investigations, to liaison with Compliance when misrepresentation is expected, and to collaborate with claims colleagues regarding case management strategies - this could be the role for you.  We are looking for a candidate with a high level of energy who will leverage their claims management experience and analytical skills in a collaborative team environment. 

How you will contribute:

• Audit files with the ability to handle multiple priorities simultaneously to prevent, detect and mitigate suspicious activity.

• Triage files with case managers, clinical and vocational staff.

• Coordinate background checks and surveillance with vendors.

• Manage and prioritize a group of claims on an ongoing basis while maintaining appropriate documentation.

• Obtain all pertinent and necessary information to evaluate claim credibility.

• Use investigative tools, may testify in court cases and provide depositions related to claim disputes based on technical expertise

What you will bring with you:

• Ability to work with a diverse range of people

• 3+years’ experience managing Group Disability Claims, strongly preferred.

• Demonstrated expert analytical skills with the ability to think creatively and address the strengths and weaknesses of a claim and the fine distinctions in contract language

• Excellent written and verbal communication skills with client service orientation

• Must be able to work independently and a team environment

• Ability to conduct detailed claimant interviews

• Solid critical thinking skills as well as the ability to negotiate with people

Salary:  

$72,500 - $108,800

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. 

Not ready to apply yet but want to stay in touch?   Join our talent community to stay connected until the time is right for you! 

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.