Principal Consultant shaping sustainability and governance in mining and metals industries. Leading high - impact project delivery and influencing corporate strategies in responsible operations.
About the role
- Investigator responsible for conducting investigations into fraud related to Disability claims at Sun Life. Engaging with various stakeholders and utilizing advanced data analytics to mitigate risks.
Responsibilities
- Conduct a formal investigation when there is suspected misrepresentation or alternate employment on a Disability claim
- Engage in phone and email communication with plan sponsors, service providers, disability case managers, and other third parties
- Leverage advanced, open-source search techniques, data analytics tools, and digital investigation frameworks to support organizational objectives and inform strategic decision-making
- Document findings utilizing technology platforms and formal reports
- Conduct phone interviews with plan members
- Prepare and deliver compelling presentations of investigative findings to internal stakeholders, across various levels
- Engage in collaborative efforts between other FRM teams and Disability to identify and investigate claim misrepresentation or suspected fraud
- Maintain accurate documentation of all case notes and findings in an internal case management system
- Identify fraud trends and support data analytics solutions to mitigate the newly identified risk
- Remain current and up to date on industry trends/education/products/privacy laws/etc
- Contribute to the ongoing evolvement of the Disability Investigations process
Requirements
- Experience and formal training in investigations, preferably within insurance or group benefits
- Formal interview training and/or experience
- Exceptional OSINT research skills
- Strong presentation and communication skills with experience utilizing Microsoft Teams
- Experience preparing comprehensive report summaries of investigative findings
- Ability to apply critical thinking and innovative approaches when analyzing investigative findings
- Take ownership of decisions and their outcomes while maintaining accountability for results
- Demonstrated success as an individual contributor who can also effectively collaborate within a team
- Knowledge and understanding of contractual language, administration guidelines, and provincial and federal legislation
- Knowledge in Disability claims, including short and long-term claims and Group Benefits, an asset
- Familiarity with medical terminology, an asset
- Bilingualism (French, English) required for Quebec only for the frequent interactions with English and French-speaking colleagues or internal partners across Canada or worldwide
Benefits
- A hybrid organization facilitating a better work/life balance
- Flexible Benefits
- Pension Plan
- Stocks Ownership
- Time off
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