Case Manager

Sun Life

. Reviews and investigates disability claims using telephone and written contact with claimants, employers/supervisors, credit unions, treating physicians, and other applicable parties .

Posted 11/10/2026full-timeRemote • Maine • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in adjudicating disability claims, including calculating benefit payments and interpreting disability contract language, while maintaining compliance with state and federal regulations. Exhibits strong analytical, communication, and organizational skills to effectively manage claims and collaborate with various stakeholders.

Highest-signal resume keywords

Claims AdjudicationMedical Terminology KnowledgeTPA LicensingAnalytical SkillsCommunication Skills

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Claims InvestigationBenefit CalculationDocumentation ManagementRisk AssessmentProblem Solving

Soft Skills

Interpersonal SkillsCustomer Service SkillsTime ManagementDetail OrientedTeam Collaboration

Tools & Technologies

MS WordMS ExcelEmail Systems

Certifications & Qualifications

TPA Licenses

Industry Keywords

Disability ClaimsClaim PoliciesState RegulationsFederal RegulationsVocational Rehabilitation

About the role

Key responsibilities & impact

Reviews and investigates disability claims using telephone and written contact with claimants, employers/supervisors, credit unions, treating physicians, and other applicable parties
Adjudicates claims accurately and fairly in accordance with contracts, claim policies and procedures, and state and federal regulations
Meets productivity and quality standards based on product line
Utilizes appropriate medical and risk resources and transfers claims to the appropriate risk level in a timely manner
Conducts in-depth pre-existing condition or contestable investigations when applicable
Calculates benefit payments, including partial disability, integration with other income sources, survivor, residual disability, and cost-of-living-adjustment benefits
Develops and maintains thorough claim documentation
Documents and communicates claim decisions
Coordinates return to work, working with vocational rehabilitation as necessary
Guides claims management activities of insurance company clients’ claims analysts on co-managed claims when warranted
Collaborates with managers and senior consultants to provide technical assistance and problem-solving strategies
Participates in industry or client meetings
Performs other duties and responsibilities as requested or needed

Requirements

What you’ll need

Minimum 3 year previous work experience required
Attains and maintains appropriate TPA licenses in accordance with the Claims Licensing Policy
In-depth analytical, critical thinking, problem solving and decision-making skills
In-depth level of knowledge of medical terminology and conditions
Ability to interpret and communicate disability contract language
Excellent verbal communication skills, with the ability to be both pleasant and professional
Strong written communication skills
Solid mathematical skills
Ability to work well independently and in a team environment
Strong interpersonal and customer service skills
Ability to initiate and prioritize regular work duties and projects
Detail oriented, organized, the ability to multi-task, and strong time management skills
Strong computer skills, proficient in a PC environment and MS Word, Excel, and email systems
Ability to work professionally and effectively with co-workers, clients, claimants, vendors and others with whom FSRMS does business

Benefits

Comp & perks

Generous vacation and sick time
Market-leading paid family, parental and adoption leave
Medical coverage
Company paid life and AD&D insurance
Disability programs
Partially paid sabbatical program
401(k) employer match
Stock purchase options
Employer-funded retirement account
Flexible, inclusive and collaborative work environment
Career growth support