Benefit Analyst I, LWOP

Posted Yesterday
Be an Early Applicant
Hiring Remotely in United States of America
Remote
55K-82K Annually
Entry level
Fintech • Payments • Financial Services
The Role
As a Benefit Analyst, you will manage a caseload of life waiver claims, conducting eligibility reviews and making claim decisions based on medical evidence and policy provisions. The role requires strong analytical skills and communication to document and explain claim decisions to stakeholders while prioritizing caseloads effectively.
Summary Generated by Built In

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; maintain appropriate documentation

  • Assess occupational job duties and rehabilitation opportunities by working with vocational staff

  • Appropriately use investigative tools; may testify in court cases, respond to State Insurance Department complaints/requests, and provide depositions related to claim disputes based upon technical expertise. 

What you will bring with you:  

  • Ability to work with a diverse group of people

  • Able to work in a team environment 

  • Excellent written and verbal communication skills 

  • Strong customer service orientation 

  • Ability to speak directly with claimants in telephone interviews or in person with other Senior Analysts 

  • Strong analytical and communication skills with claims experience or transferrable experience, 

  • Broad grasp of claims practices; related work experience in claims or in a medical field, particularly in the areas of worker's compensation, long- term care or medical claims. 

  • Strong negotiation skills 

Do you see yourself in this role even if you haven’t checked all the boxes above? We welcome all talented candidates and are committed to a culture that represents diversity in all forms. If you think you might thrive in this setting, we would love to hear from you.  

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!  

Life is brighter when you work at Sun Life  

  • Excellent benefits and wellness programs to support the three pillars of your well-being – mental, physical and financial – including generous vacation and sick time, market-leading paid family, parental and adoption leave, a partially-paid sabbatical program, medical plans, company paid life and AD&D insurance as well as disability programs and more  

  • Retirement and Stock Purchase programs to help build and enhance your future financial security including a 401(k) plan with an employer-paid match as well as an employer-funded retirement account   

  • A flexible work environment with a friendly, caring, collaborative and inclusive culture   

  • Great Place to Work® Certified in Canada and the U.S.   

  • Named as a “Top 10” employer by the Boston Globe's “Top Places to Work” two years running  

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.  

 Salary Range: $54,900 - $82,400

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."                              

Sun Life Financial is a leading provider of group insurance benefits in the U.S., helping people protect what they love about their lives. More than just a name, Sun Life symbolizes our brand promise of making life brighter -for our customers, partners, and communities. Join our talented, diverse workforce and launch a rewarding career. Visit us at www.sunlife.com/us to learn more.  

 At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.   

  #LI-remote    

Our Affirmative Action Program affirms our commitment to make reasonable accommodation to the known physical or mental limitation 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.

At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.

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

Job Category:

Claims - Life & Disability

Posting End Date:

27/02/2025

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.

The Company
Toronto, Ontario
499 Employees
On-site Workplace

What We Do

A UK company, Sun Life Financial of Canada is focused on building excellent customer service by offering the highest levels of customer care. We have been serving customers in the UK for over 100 years

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