- (Reference :CLA02430 )
Abilities Case Manager
- As soon as possible
- To be discussed
The Abilities Case Manager (ACM) is a member of the team responsible for assessing and managing claims to resolution. This includes determining if the claimants are eligible for benefit payments and developing appropriate actions plans for each claim. The ACM is required to communicate frequently with claimants, policyholders, lawyers, physicians and other departments
Assesses various types of claims for eligibility for benefits and makes decisions within service standards: assessment includes evaluation of medical documentation and contractual provisions and pursuing additional information if necessary to make a sound decision
Communicates with claimants, policyholders, lawyers, physicians and other departments by electronic mail, telephone, written correspondence and occasionally in person
Handling difficult phone calls from agitated and sometimes hostile callers as a result of the decision to decline benefits
Commitment to quality service
Develop, communicate and execute case management plans
Conducting telephone interviews focused on gaining relevant information not evident in existing documentation
Identify and assess non medical barriers pre and post disability functional capacity and medical management in order to positively impact recovery and resolution
Updates information on claim-paying computer system
Negotiating and developing return to work plans with plan members and plan sponsors
Bilingualism (French and English, written and spoken)
Excellent communication skills
Ability to handle calls of a sensitive or emotionally charged nature
Well organized individual with strong analytical skills, excellent problem solving ability and can work with a minimum of supervision
Must have a positive attitude, a commitment to quality service and be able to cope with the stress inherent in the nature of disability claims assessing, including high work volumes
Good keyboarding skills
Able to work in a PC environment
Attention to detail is important due to the complexity of claims situations and contractual considerations
Adaptability and flexibility are key to success in this role
Strong team player, with a high interest in working in a cross-functional team environment
Medical experience obtained through claims assessing, underwriting, nursing and health profession
Knowledge of disability products and administration
Experience with Ultera, Chess, Excel
At the offer stage, must complete Reliability Screening under the Government of Canada Security Policy and be granted "Reliability Status" as a result of the screening.
Sun Life Financial: focused on excellence
Sun Life Financial, chartered in Montreal in 1865, is a leading financial services organization providing a diverse range of life and health insurance, pension and investment products and services to individuals and corporate customers. Sun Life and its partners today have operations in key markets worldwide, including Canada, the United States, the United Kingdom, India and Asia.
In Quebec, the Sun Life team is made up of 1400 employees and 700 financial advisors. The company was named to the list of Canada’s Top 100 Employers, published by Mediacorp Canada Inc. and Maclean’s magazine, and demonstrates community involvement through its wide-ranging philanthropy program.
Be part of a high-performance team that values self-starters and team players, along with professionalism, respect and trust.