Senior Consultant I, LTD Claims Investigation Services

Sun Life Financial, Inc.

$72K — $108K *
Finance & Insurance
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 3+ years of managing Group Disability Claims is strongly preferred.
  • Exceptional analytical skills with a creative approach to claim assessments.
  • Strong written and verbal communication skills focused on client service.
  • Ability to work both independently and collaboratively in a team environment.
  • Capacity to conduct thorough claimant interviews and negotiate effectively.

Responsibilities

  • Audit claim files to identify and mitigate suspicious activities.
  • Triage case files with case managers and clinical staff.
  • Coordinate background checks and vendor surveillance activities.
  • Manage and document a portfolio of claims systematically.
  • Gather necessary information to assess claim credibility.
  • Utilize investigative tools and potentially testify in court regarding claims disputes.

Benefits

  • Generous vacation and sick time allowances.
  • Market-leading family, parental, and adoption leave.
  • Comprehensive medical coverage.
  • Company-paid life and AD&D insurance.
  • Disability programs and partially paid sabbatical options.
  • 401(k) employer match and stock purchase options.
  • Employer-funded retirement account with career growth support.
Full Job Description
Job Description:

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. Our team members and leaders are expected to foster connection and teamwork by being present in the office at least 2 days per week.

The Opportunity

The Senior Consultant I, LTD Claims Investigation Services assists in obtaining information that may be relevant to the claims investigation and adjudication process. Senior Consultants (CIS) assist Case Managers to complete investigations that reflect strong claims fundamentals. If you have the desire to assist in technology driven public information searches and activities investigations, to liaison with Compliance when misrepresentation is expected, and to collaborate with claims colleagues regarding case management strategies - this could be the role for you. We are looking for a candidate with a high level of energy who will leverage their claims management experience and analytical skills in a collaborative team environment.

How you will contribute:
  • Audit files with the ability to handle multiple priorities simultaneously to prevent, detect and mitigate suspicious activity.
  • Triage files with case managers, clinical and vocational staff.
  • Coordinate background checks and surveillance with vendors.
  • Manage and prioritize a group of claims on an ongoing basis while maintaining appropriate documentation.
  • Obtain all pertinent and necessary information to evaluate claim credibility.
  • Use investigative tools, may testify in court cases and provide depositions related to claim disputes based on technical expertise


What you will bring with you:
  • Ability to work with a diverse range of people
  • 3+years' experience managing Group Disability Claims, strongly preferred.
  • Demonstrated expert analytical skills with the ability to think creatively and address the strengths and weaknesses of a claim and the fine distinctions in contract language
  • Excellent written and verbal communication skills with client service orientation
  • Must be able to work independently and a team environment
  • Ability to conduct detailed claimant interviews
  • Solid critical thinking skills as well as the ability to negotiate with people


Salary:

$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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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.

Job Category:

Claims - Life & Disability

Posting End Date:

30/09/2026

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