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Disability Claims Examiner

1 month ago

Montreal, Quebec, Canada Financière Sun Life Full time
Job Title: Disability Adjudicator

Join Financière Sun Life as a Disability Adjudicator and play a critical role in assessing and managing disability claims to resolution. As a key member of our team, you will be responsible for determining plan members' entitlement to benefit payments and developing appropriate action plans for each claim.

Main Responsibilities:
  • Assess new short-term disability claims for eligibility and benefit entitlement by reviewing contractual, medical, and occupational information.
  • Manage short-term disability claims during the acute period of absence, ensuring a smooth transition to Disability Case Managers as required.
  • Develop and maintain appropriate action plans to influence early and timely recovery, where appropriate.
  • Communicate effectively with plan members, plan sponsors, and other stakeholders to obtain information and convey claim status, action plans, and decisions.
  • Collaborate with lawyers, physicians, and other departments to ensure accurate and timely claim processing.
Requirements:
  • Excellent communication and interpersonal skills.
  • Ability to handle sensitive or emotionally charged calls.
  • Strong analytical and problem-solving skills, with a high level of accuracy and attention to detail.
  • Positive attitude, commitment to quality service, and ability to cope with high work volumes and stress.
  • Good keyboarding skills and ability to work in a PC environment.
  • Adaptability, flexibility, and strong team player skills.
  • Strong decision-making skills and medical experience obtained through claims assessing, underwriting, nursing, and health professions.
  • Bilingualism (French and English) is required for frequent interactions with English and French-speaking colleagues and internal partners.
What We Offer:
  • A collaborative and interactive team environment.
  • Access to short-term assignments or 'Gigs' across the organization to develop new skills and connections.
  • Charitable giving through our You Give, We Give program, with the option to match contributions.
  • Care Days for self-care or care of others, and Sick Days to support well-being.

Financière Sun Life is committed to diversity and inclusion, and we welcome applications from qualified individuals from all backgrounds. If you require accommodation in the application process or need job postings in an alternative format, please email thebrightside@sunlife.com.