Senior claims specialist analyzing, negotiating, and settling auto and general liability claims. Supporting clients, brokers, litigation, and Independent Adjusters for Canadian TPA Helmsman.
About the role
- Quality Analyst overseeing and providing feedback on Disability claim processes at Sun Life. Collaborating with teams to ensure operational consistency and meet service levels.
Responsibilities
- Conduct quality reviews focusing on case management principles as well as overall case management excellence of assigned disability claims files; record quality assurance results using audit tools
- Review new claim decisions and/or change of definition decisions to assure the quality of the decision as defined by our contract, philosophy and practices
- Meet service levels for quality, quantity and timeliness (individual and team)
- Provide feedback on evaluation along with suggestions of improvement
- Remain current on Group Life and Disability practices and processes
- Provide input on trends to support actionable recommendations for quality improvement
- Participate in calibration sessions to ensure consistency in the application of the measures and to ensure program objectives are met
- Provide subject matter expertise input into Disability process related inquiries
- Provide feedback on the assessment with strong supporting rationale, when there is a disagreement between Quality and Operation
Requirements
- Long Term Disability Claims Management experience 3-5 years
- Minimum of 3 years of experience as a Disability Case Manager
- Experience in auditing, sampling and reconciliation
- Knowledge of Organizational Effectiveness, Group Benefits and understanding of GB strategy
- Knowledge of other Group Benefits areas
- In-depth level of knowledge of disability claims (STD, LTD, and Health Management) processes, controls and systems (3-5 years of long term disability claims experience)
- PC knowledge (Windows XP, Excel, Word)
- Bilingualism (French, English, both oral and written) is required for the frequent interactions with English and French-speaking colleagues or internal partners across Canada and worldwide.
Benefits
- Access to short-term assignments or ‘Gigs’ across the organization, to help you develop new skills and connections.
- A collaborative and interactive team environment
- Charitable giving through our You Give, We Give program lets you give back to your community – and in many cases, we’ll match your contributions.
- Care Days available for self-care or care of others (i.e., family or others you may support) and Sick Days to support your well-being.
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