Senior Manager leading health insurance claims operations at Sun Life, overseeing team management and complex claims processing. Collaborating with partners to enhance customer service and business growth.
Responsibilities
Oversee complex claims operations
Manage a high-performing team
Direct the evaluation, investigation, negotiation, and settlement of complex claims
Ensure optimal balance between policyholder interests and company objectives
Supervise, mentor, and grow a talented claims team
Monitor workflow and implement efficiencies
Collaborate with third-party administrators, brokers, agents, policyholders, vendors, and legal counsel
Requirements
5+ years of medical stop loss insurance or health insurance claims experience required
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
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