Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.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.

At Sun Life, we're driven by our Purpose: helping our Clients achieve lifetime financial security and live healthier lives. Our values shape how we work: caring, authentic, bold, inspiring, and impactful.

When you join Sun Life, you'll work with passionate colleagues and empowering leaders who support your growth and celebrate your contributions, so you can make a meaningful difference in our Clients' lives.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.  

Senior Financial & Subrogation Liaison

Job Summary:

This position will work closely with our subrogation vendor on investigating and pursuing subrogation from appropriate parties for recovery on STD and LTD claims. This includes making decisions about liability/compensability, evaluating losses, and negotiating settlements.

Skills & Responsibilities:

• Proven ability to train Claims department including LTD and STD
• Demonstrated ability and willingness to give candid and meaningful feedback to Claims
• Expert technical ability in interpreting and communicating disability contract language
• Technical expert in interpreting policy language and utilizing the parameters to calculate complex subrogation and monthly benefit calculations
• Attains and maintains appropriate TPA licenses in accordance with the Claims Licensing Policy.

• Confidently negotiate claims to fairly resolve and reduce liability for Fullscope RMS and Client Carrier Partners
• Proficiently and proactively handle the claim file through various phases of subrogation. Independently review the applicability of coverage and civil law as well as local statues.
• Communicates with various parties associated with the claim. Respond to written and verbal inquiries in a timely and professional manner, ensuring compliance within all company and statutory guidelines.
• Effectively and independently negotiates settlements with insureds and third parties
• Works with and manage costs of outside vendor
• Identify subrogation opportunities and work with vendor to obtain recoveries
• Services as a subject matter expert to the claims department in all matters associated with third party and subrogation pursuit, including managing workflow, responding to third-party and subrogation vendor needs, as well as training and coaching employees.
• Supports the development of an organization focused on quality claims management
• Applies technical knowledge to support departmental development, special projects, and programs.
• Demonstrates proficient understanding of carrier/clients and accurate application of client specifics in client brand protection by the team.
• Identifies and communicates developmental areas which need improvement within the analyst’s or client’s block of business.
• Provides developmental feedback to team members on case level actions within the context of a training and coaching relationship.
• Assists in the design and delivery of training programs
• Completes special projects as necessary
• Maintains an acceptable level of technical acumen, policy and laws
• Delivers dependable, accurate, timely service and build strong relationships with clients and colleagues
• Conducts internal and external claims audits & training seminars
• Participates in the development of internal policies and procedures
• Participates in industry and client meetings as well as client presentations and training.

Qualifications:

• Minimum 3 years previous related work experience as well as specific disability product line experience required.  5 years of LTD and STD experience required.
• Excellent interpersonal skills to communicate and negotiate with other parties and conduct investigations required
• Proven interpersonal, analytical and negotiation abilities required
• Ability to provide information in a clear, concise manner, ability to build effective relationships
• Ability to exercise independent judgment, effectively make sound business decisions, and resolve unique and challenging problems
• Advanced analytical and problem-solving skills, ability to multi-task and to independently prioritize competing demands/requests within given time constraints
• Excellent conflict resolution skills
• Familiarity with Claims administration systems
• Proficiency in Microsoft Office suites (Excel, PowerPoint, Word, Outlook)

Progression Milestones:

Maintains TPA licensing by completing continuing education

Salary Range: $72,500 - $108,800

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.

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We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive.  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.

Life is brighter when you work at Sun Life

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.  Proudly Great Place to Work® Certified in Canada and the U.S., we’ve also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row.  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. Please email [email protected] to request an accommodation.

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

We do not require or administer lie detector tests as a condition of employment or continued employment.

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.