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Claims - Health & Dental

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

At Sun Life, we look for optimistic people who want to make life brighter for ourClients.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 challengedbyworking withdynamic colleaguesto find new and innovative ways to make Sun Life the best benefits company in America.

The Health and Risk Solutions

The opportunity

Overpayment Recovery Analyst

How you will contribute

  • Track, calculate and pursue overpayments identified within Stop Loss department. This includes researching of files, having full understanding of claims, type of overpayment, overpayment resolution options and total knowledge of systems used by claims department
  • Follow up of overpayment requests which may include discussions with Administrator, Claim Analyst, Broker both internal and external customers via conversation and/or letters, ability to provide detailed descriptions of circumstances around overpayment and provide specific details from claim files, conduct discussions with internal claims analysts
  • Provide monthly current recovery reports (analysis, trending, actions, status), contacting external customers
  • (Administrator/Broker/outside
  • Receive escheatment report, investigate customer data and provide data to banking for potential stop pay/re-issue of checks

What you will bring with you

  • Ability to work with a diverse range of people
  • Requires expert level understanding of the Stop Loss claims process or Medical Claims with respect to how overpayments are determined, processes for write offs, succinct, detailed communication to external customers requesting monies.
  • 5+ years understanding of first dollar stop loss claims or medical claims, Prior experience in medical or Stop Loss claim adjudication
  • Proficient in Excel with advanced skills, including complex formula construction, pivot table manipulation, Vlookup, queries creation
  • Adept knowledge in navigating and utilizing SharePoint features at an intermediate level, including document management, tracker creation, and basic site administration
  • Strong understanding of business and relationship building with external customers
  • Highly skilled verbal and written communication 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

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 Globes 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.

the salary range for this position is

If you are a California resident,

  • Southern region $74,600-$111,900 annually
  • Central region $78,700-$118,100 annually
  • Northern region $84,200-$126,300 annually

, the salary range for this position is $71,200-$106,800 annually.

If you are a Colorado resident

, the salary range for this position is $84,200-$126,300 annually.

If you are a New York resident

, the salary range for this position is $78,700-$118,100 annually.

If you are Washington resident

We consider various factors in determining actual pay including your skills, qualifications, and experience. In addition to salary, this position is eligible for incentive awards based on individual and business performance as well as a broad range of competitive benefits.

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

to request an accommodation.

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

recruitingUS@sunlife.com

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

Posting End Date

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.