Bilingual Investigator, Fraud Risk Management Disability Program

You are as unique as your background experience and point of view. Here youll be encouraged empowered and challenged to be your best self. Youll 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 youll 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:

Fraud management is increasingly important to order to serve Sun Lifes clients as industry leaders the Canadian Operations Fraud Risk Management area will identify mitigate and respond to threats using various tools technologies and strategies.

Reporting to the Fraud Risk Management (FRM) Disability Manager the Investigator is responsible for conducting thorough investigations into situations involving possible misrepresentation fraud and abusive activities related to Group Benefits claims with a primary focus on Disability files. This role requires a detail-oriented professional who can independently assess and investigate identified fraud leads while maintaining the highest standards of accuracy and confidentiality. The successful candidate will be responsible for gathering organizing and analyzing complex data to build thorough case files that document all aspects of each investigation.

What will you do

• Conduct a formal investigation when there is suspected misrepresentation or alternate employment on a Disability claim.
• Engage in phone and email communication with plan sponsors service providers disability case managers and other third parties.
• Leverage advanced open-source search techniques data analytics tools and digital investigation frameworks to support organizational objectives and inform strategic decision-making.
• Document findings utilizing technology platforms and formal reports
• Conduct phone interviews with plan members
• Prepare and deliver compelling presentations of investigative findings to internal stakeholders across various levels.
• Engage in collaborative efforts between other FRM teams and Disability to identify and investigate claim misrepresentation or suspected fraud.
• Maintain accurate documentation of all case notes and findings in an internal case management system.
• Identify fraud trends and support data analytics solutions to mitigate the newly identified risk
• Remain current and up to date on industry trends/education/products/privacy laws/etc.
• Contribute to the ongoing evolvement of the Disability Investigations process.

What do you need to succeed

• Bilingualism (French English both oral and written) is required for the frequent interactions with English and French-speaking colleagues or internal partners across Canada and worldwide.
• Experience and formal training in investigations preferably within insurance or group benefits
• Formal interview training and/or experience
• Exceptional OSINT research skills
• Strong presentation and communication skills with experience utilizing Microsoft Teams
• Experience preparing comprehensive report summaries of investigative findings
• Ability to apply critical thinking and innovative approaches when analyzing investigative findings.
• Take ownership of decisions and their outcomes while maintaining accountability for results
• Demonstrated success as an individual contributor who can also effectively collaborate within a team
• Knowledge and understanding of contractual language administration guidelines and provincial and federal legislation
• Knowledge in Disability claims including short and long-term claims and Group Benefits an asset
• Familiarity with medical terminology an asset

Unique Requirements

Reliability Status: As a condition of the role the successful candidate must obtain a Government of Canada Reliability Status security clearance through Sun Life.

Whats in it for you

• A hybrid organization facilitating a better work/life balance
• We are proud to be on the 2024 Best Workplaces in Canada list by Great Place to Work!
• Agile behaviours faster decisions and learning as we go.
• Being part of our journey in developing the next greatest digital experience
• Flexible Benefits Pension Plan & Stocks Ownership and time off.

#LI-Hybrid

The Base Pay range is for the primary location for which the job is posted. It may vary depending on the work location of the successful candidate or other addition to Base Pay eligible Sun Life employees participate in various incentive plans payment under which is discretionary and subject to individual and company performance. Certain sales focused roles have sales incentive plans based on individual or group sales results.

Diversity and inclusion have always been at the core of our values at Sun Life. A diverse workforce with wide perspectives and creative ideas benefits our Clients the communities where we operate and all of us as colleagues. We welcome applications from qualified individuals from all backgrounds.

Persons with disabilities who need accommodation in the application process or those needing job postings in an alternative format may e-mail a request to .

We are proud to be a hybrid organization that offers our employees the choice and flexibility to work from both the office and virtually based on the needs of the business our Clients and you! Several work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.

We may use artificial intelligence to support candidate sourcing screening interview scheduling.

We thank all applicants for showing an interest in this position. Only those selected for an interview will be contacted.

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