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.
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Job Description:
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…