Sr Medical Claims Analyst

You are as unique as your background, experience and point of view. Here, you'll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.

Job Description:

The Claims Analyst is responsible for ensuring the accurate and timely processing of medical claims/exceptions for reimbursements to our members. The incumbent will be assigned to handle claims for various clients. There are clearly defined expectations with regard to service targets, productivity standards as well as set levels for related competencies such as: teamwork, customer service, problem-solving, decision-making and giving and receiving feedback.

What will you do?

Reviewing and adjudicating of all aspects and all types of health claims in order to determine appropriate eligibility based on the terms of the group contract, as well as providing excellent service to our members and clients.

What will you need to succeed?

• Knowledge of Group Health Systems
• Knowledge of medical/medication terminology
• Knowledge of insurance or financial services products
• Experience in a customer service environment or previous office experience
• As this position is posted in several locations, we specify that bilingualism (French, English, both oral and written) is required for Quebec only for the frequent interactions with English and French-speaking colleagues or internal partners across Canada or worldwide.
• Medical analyst experience
• Keen ability to provide quality service while achieving productivity quotas
• Good PC skills including proficiency with MS Word, Excel and Lotus Notes
• Proficient keyboarding skills
• Basic mathematical skills

What is in it for you?

• 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.
• Stock Ownership Program gives you the chance to invest in Sun Life and get a company match.
• Flexible Benefits from the day you join to meet the needs of you and your family.
• Lumino Health Virtual Care gives you quick access to doctors and up to four free mental health coaching or counselling sessions for you or your eligible dependents and the option to continue care with a registered mental health professional using your benefits coverage.
• Live virtual group fitness, stretch break and meditation classes. Work-Life Balance
• As a hybrid organization, you and your leader use business and Client needs to choose where you work, at home or in the office.

The Base Pay range is for the primary location for which the job is posted. It may vary depending on the work location of the successful candidate or other factors. In addition to Base Pay, eligible Sun Life employees participate in various incentive plans, payment under which is discretionary and subject to individual and company performance. Certain sales focused roles have sales incentive plans based on individual or group sales results.

Diversity and inclusion have always been at the core of our values at Sun Life. A diverse workforce with wide perspectives and creative ideas benefits our clients, the communities where we operate and all of us as colleagues. We welcome applications from qualified individuals from all backgrounds.

Persons with disabilities who need accommodation in the application process or those needing job postings in an alternative format may e-mail a request to thebrightside@sunlife.com.

At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.

We thank all applicants for showing an interest in this position. Only those selected for an interview will be contacted.

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