Disability Claims Consultant

Job Description

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This Position is for a 1 Year Contract

As a Disability Claims Consultant, you will be responsible for assessing and managing disputed disability claims that are referred to the Appeal team through Sun Life’s disability appeal process.

What will you do?

• Assess disputed disability claims in accordance with our claims practices and procedures within the services standards set for the organization

• Demonstrate an excellent knowledge of group disability insurance and claims management strategies

• Take action on all appeals where information gaps are identified throughout the appeal review by obtaining any relevant outstanding information and/or requesting appropriate third party assessments

• Provide support to Disability Case Managers on optimal claims decisions, ensuring that all components including the contract, medical, functional and vocational components are considered as part of the overall assessment of the claim decision

• Work with Team Managers to identify and close any gaps on case management and decision deficiencies that surface through coaching

• Understand key components to claims decisions, including a focus on the need to evaluate and weigh the totality of information and the impact decisions have on clients

• Communicate with clients with respect and empathy throughout the appeal process and tactfully deliver final appeal decisions in a sensitive manner

• Report on emerging trends so that they can be addressed and where suitable, learnings can be leveraged nationally

• Contribute to a dynamic work environment by identifying opportunities to continuously improve processes to better meet our service excellence, quality and financial commitments to our clients
  

What do you need to succeed?

• Exceptional decision making and case management skills focused on positive outcomes for plan sponsor, plan member and Sun Life Financial

• Critical thinking and stellar client service skills

• Strong analytical, organizational and problem solving skills

• Solid knowledge of group disability insurance policy and coverage concepts

• Excellent listening skills and capacity for empathy

• Exceptional verbal and written communication skills

• Ability to present case reviews in group settings and collaborate in group discussions

• Ability to evaluate and identify key information relevant to each case to present to the Appeal committee

• Ability to deliver constructive decisions and feedback in a tactful and sensitive manner

• Adaptability, flexibility and strong decision making skills

• As this position is posted in several locations, we specify that bilingualism (French, English, both oral and written) is required for Quebec only for the frequent interactions with English and French-speaking colleagues or internal partners across Canada or worldwide.
  

Assets:

• A bachelor's degree or equivalent business experience

• 3-5 years Disability Claims experience

• Bilingualism is an asset
  

Reasons why you should join Sun Life?

• A friendly, collaborative and inclusive culture

• A collaborative and interactive team environment

• Working together, sharing common values and encouraging growth & achievement