Senior Specialist, Integrated Absence & STD
Join to apply for the Senior Specialist, Integrated Absence & STD role at Sun Life
Senior Specialist, Integrated Absence & STD
Join to apply for the Senior Specialist, Integrated Absence & STD role at Sun Life
S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. 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.
Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.
Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work.
The Case Specialist II, Integrated Absence & STD acts under the general supervision of a Senior Manager managing claims including FMLA, PFL, ADA and/or other leave programs in conjunctions with Short Term Disability (STD) benefits. This role may take on more complex cases as they develop their ability to analyze and interpret claims.
Reviews and investigates disability, FMLA, PFL, ADA and other leave claims thoroughly by using telephone and written contact with the applicable parties, (claimant, employer/supervisor, credit union, treating physician, etc.) to gather pertinent data to analyze the claim(s)
Adjudicates claims accurately and fairly in accordance with federal, state, local, and ERISA regulations and the STD contract, appropriate claim policies and procedures, meeting productivity and quality standards
Utilizes appropriate medical, vocational, and risk resources, adhering to referral polices, and transferring claims to the appropriate risk level in a timely manner
Calculates benefit payments, which may include partial disability or PFL or other benefits, integration with other income sources, survivor benefits, residual disability benefits, cost of living adjustments, etc.
Develops and maintains on-line claim data (and paper file if applicable)
Documents and communicates claim decisions
Acts with a sense of urgency in responding to customer inquiries
Participates in in-service and training opportunities as required
Contributes to the development of internal policies and procedures
Exposure to various issues within disability and absence product lines
~ Ability to interpret and communicate disability contract language and FMLA/PFL/ADA and other leave regulation language
~ Strong interpersonal and customer service skills
~ Ability to initiate and prioritize regular work duties and projects
~ Strong computer skills, proficient in a PC environment and MS Word, Excel, and email systems
~ High School Diploma or equivalent
~1+ years of previous short-term disability and FMLA and/or PFL product line experience required
At our company, we are committed to pay transparency and equity. 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. Join our talent community to stay connected until the time is right for you!
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.
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. 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. For applicants residing in California, please read our employee California Privacy Policy and Notice.
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.
Employment type Full-time
Industries Financial Services and Insurance
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