Claim Analyst

Vous êtes unique, comme le sont votre parcours, votre expérience et votre façon de voir les choses. Ici, on vous encourage et on vous motive à donner le meilleur de vous-même, et on vous donne les moyens de le faire. Vous travaillerez avec des collègues dynamiques – experts dans leur domaine – qui sont impatients de partager leurs connaissances avec vous. Vous aurez des gestionnaires inspirants qui vous aideront à développer votre potentiel et à atteindre de nouveaux sommets. Chaque jour, vous aurez de nouvelles occasions de rendre la vie de nos Clients plus radieuse – ils sont au cœur de tout ce que nous faisons. Découvrez comment vous pouvez faire une différence dans la vie des gens, des familles, des collectivités – ici et partout dans le monde.

De scription de poste :

Appraises and approves claims within prescribed approval limits, performs initial review of claims beyond authorized approval limits and submits recommended course of action to Claims Manager.

Specific Accountabilities:

• Appraises and approves death and living benefit claims, both individual and group insurance, within approval limits. Secures Underwriting, Legal and/or Medical input where necessary.
• Appraises claims beyond authorized approval limits, prepares written analysis and recommended course of action and submits to Claims Manager for review and approval.
• Reviews and approves request within disbursement approval limits and initially reviews and submits to Claims Manager for approval those beyond disbursement approval limits.
• Attends to claim inquiries ranging from basic to complex in nature.
• Represents Sun Life in mediation required by the Insurance Commission and Court hearing, 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
• Detailed-oriented, organized, systematic.
• Patient and interested to read and familiarize self with provisions of the law, medical materials and review and scrutinize various documents.
• Can work independently and is decisive.
• Can work ably under pressure and can 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 required LOMA and ICA courses under Claims Career Development Program.
• With good attendance and punctuality record.

Catégorie d'emploi :

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