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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing complex claims within the medical stop loss and health insurance sectors, emphasizing leadership, analytical problem-solving, and effective stakeholder management. Proficient in claims management systems and maintaining high customer service standards.
Highest-signal resume keywords
Medical Stop Loss Insurance ExperienceClaims Management Systems ProficiencyLeadership SkillsAnalytical Problem-Solving AbilitiesStakeholder Management Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ProcessingClaims InvestigationNegotiationPerformance ManagementProcess Efficiency ImplementationData AnalysisClaims Practices KnowledgeState and Federal Laws Knowledge
Soft Skills
Communication SkillsMentoringCollaborationCustomer-Facing Skills
Tools & Technologies
Claims Management SystemsSun Life Products
Industry Keywords
Health Insurance ClaimsPolicyholder InterestsThird-Party AdministratorsBrokersAgentsVendorsLegal Counsel
About the role
Key responsibilities & impact- Lead evaluation, investigation, negotiation, and settlement of complex claims
- Balance policyholder interests with company objectives
- Supervise, mentor, and develop the claims team
- Oversee work assignments and performance management
- Monitor workflow and implement process efficiencies
- Ensure prompt and accurate claims processing
- Collaborate with third-party administrators, brokers, agents, policyholders, vendors, and legal counsel
- Drive business growth and maintain Sun Life's customer-service reputation
Requirements
What you’ll need- Ability to work with a diverse range of people
- 5+ years of medical stop loss insurance or health insurance claims experience required
- Previous management/leadership experience preferred
- Proven leadership skills and deep industry expertise
- Strong analytical and problem-solving abilities
- Experience in stakeholder management and customer-facing roles
- In-depth knowledge of claims practices, state and federal laws
- Excellent communication and negotiation skills
- Ability to analyze and communicate complex data and trends
- Proficiency with claims management systems and Sun Life products
Benefits
Comp & perks- Generous vacation and sick time
- 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
- Discretionary annual incentive award based on individual performance and overall business performance