Overpayment Recovery Analyst

Sun Life U.S. is one of the largest providers of employee and government benefits helping approximately 50 million Americans access the care and coverage they need. Through employers industry partners and government programs Sun Life U.S. offers a portfolio of benefits and services including dental vision disability absence management life supplemental health medical stop-loss insurance and healthcare navigation. We have more than 6400 employees and associates in our partner dental practices and operate nationwide.

Visit our website to discover how Sun Life is making life brighter for our customers partners and communities.

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. Internal candidates are not required to relocate near an office.

The opportunity: The Health and Risk Solutions Overpayment Recovery Analyst is primarily responsible for conducting reconciliations for individual stop loss claim reimbursements. Additional responsibilities include handling escheatment offsets within claims system as well as various special projects.

How you will contribute:

• Track calculate and pursue overpayments identified within Stop Loss department. This includes researching of files having full understanding of claims type of overpayment overpayment resolution options and total knowledge of systems used by claims department
• Follow up of overpayment requests which may include discussions with Administrator Claim Analyst Broker both internal and external customers via conversation and/or letters ability to provide detailed descriptions of circumstances around overpayment and provide specific details from claim files conduct discussions with internal claims analysts
• Provide monthly current recovery reports (analysis trending actions status) contacting external customers (Administrator/Broker/outside collection agency)
• Receive escheatment report investigate customer data and provide data to banking for potential stop pay/re-issue of checks

What you will bring with you:

• Ability to work with a diverse range of people
• Requires expert level understanding of the Stop Loss claims process or Medical Claims with respect to how overpayments are determined processes for write offs succinct detailed communication to external customers requesting monies.
• 5 years understanding of first dollar stop loss claims or medical claims Prior experience in medical or Stop Loss claim adjudication
• Proficient in Excel with advanced skills including complex formula construction pivot table manipulation Vlookup queries creation
• Adept knowledge in navigating and utilizing SharePoint features at an intermediate level including document management tracker creation and basic site administration
• Strong understanding of business and relationship building with external customers
• Highly skilled verbal and written communication skills

Salary:

$68200-$102300

At our company we are committed to pay transparency and equity. The salary range for this role is competitive nationwide and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills qualifications experience education and geographic addition to your base salary this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.

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We are committed to fostering an inclusive environment where all employees feel they belong are supported and empowered to thrive. We are dedicated to building teams with varied experiences backgrounds perspectives and ideas that benefit our colleagues clients and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.

Life is brighter when you work at Sun Life

At Sun Life we prioritize your well-being with comprehensive benefits including generous vacation and sick time market-leading paid family parental and adoption leave medical coverage company paid life and AD&D insurance disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match stock purchase options and an employer-funded retirement account. Enjoy a flexible inclusive and collaborative work environment that supports career growth. Were proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S. weve also been recognized as a Top 10 employer by the Boston Globes Top Places to Work for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.

We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans unless the accommodation would impose an undue hardship on the operation of our business. Please email to request an accommodation.

For applicants residing in California please read our employee California Privacy Policy and Notice.

We do not require or administer lie detector tests as a condition of employment or continued employment.

Sun Life will consider for employment all qualified applicants including those with criminal histories in a manner consistent with the requirements of applicable state and local laws including applicable fair chance ordinances.

All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability or status as a protected veteran.