Benefit Analyst I, LWOP

You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.

Job Description:

Location: We support US flexible working arrangements in the contiguous 48 states.   

At Sun Life, we look for optimistic people who want to make life brighter for our Clients. We understand the value of diverse cultures, perspectives, and identities, and want you to bring your full and authentic self to work. Every day, you’ll be empowered and challenged by working with dynamic colleagues to find new and innovative ways to make Sun Life the best benefits company in America. 

The opportunity:  

In the role of Benefit Analyst, Life Waiver of Premium, you will have the opportunity to make a difference in the lives of individuals who have experienced a disability by successfully managing a caseload of life waiver claims. Leverage your analytical and communication skills to work independently while also thriving in a team setting.

This role requires applying the appropriate policy provisions and department procedures to the medical and occupational facts of each claim to determine if the claim can be approved. This is accomplished by using an intern-disciplinary approach to determine the medical and occupational information required to make accurate claim decisions. Communication skills are needed to explain the decisions and to facilitate optimal outcomes.

How you will contribute:  

• Conduct initial claim eligibility review 

• Confirm that medical evidence supports claimant's restrictions & limitations and utilizing resources

• Obtain all pertinent and necessary evidence to evaluate claim credibility 

• Prepare written rationale of claim decision based on a review of the contractual provisions and the analysis of the medical and occupational records

• Process claims for payment by setting up on claim paying system to ensure accurate and timely receipt of benefit payments 

• Develop and document claim strategy for ongoing claim management of each file and periodically assesses the effectiveness of the action plan

• Prioritize caseload and work; …