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:

OVERALL PURPOSE:
Appraises and approves claims within prescribed approval limits, performs initial review of claims beyond authorized approval limits and submits recommended course of action to Manager. Additionally, attends to claim inquiries ranging from basic to complex in nature.

SPECIFIC ACCOUNTABILITIES:

• Appraises and approves death and living benefit claims within approval limits. Secures Underwriting, Legal, Medical input when necessary.

• Appraises claims beyond authorized approval limits, prepares written analysis and recommended course of action and submits to Manager for review and approval.

• Reviews and approves check request within CAS approval limits and initially reviews and submits to Manager for approval those beyond CAS approval limits.

• Attends to claim inquiries ranging from basic to complex in nature.

• Represents Sun Life in court hearings, as required, involving cases appraised within approval limits.

• Conducts learning sessions for Claims Services Section, as required.

SKILLS AND KNOWLEDGE REQUIRED:

• Graduate of any four-year course. A medical/allied medical science or legal background would be an advantage.

• Computer literate.

• Very good analytical, judgment, comprehension, and conceptual thinking skills.

• Detail-oriented, organized, systematic.

• Patient and interested to read, and familiarize self with provisions of the law or medical materials, and review and scrutinize various documents.

• Can work independently and decisive.

• Can work ably under pressure and multi-task.

• With strong client service orientation and good sense of urgency.

• Possesses effective interpersonal relationship skills and is a team player.

• With above average written and verbal English communication skills.

• Willing to study and pursue LOMA and ICA courses under Claims Career Development Program.

• With good attendance and punctuality record.

Job Category:

Posting End Date: