Job Description

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 6,400 employees and associates in our partner dental practices and operate nationwide. Job Description 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 the claims system, as well as various special projects. How you will contribute Track, calculate and pursue overpayments identified within the Stop Loss department. This includes researching files, having full understanding of claims, type of overpayment, overpayment resolution options and full knowledge of systems used by the claims department. Follow up on 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. 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. Proficiency in Excel with advanced skills, including complex formula construction, pivot table manipulation, VLOOKUP, and query 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 $68,200–$102,300 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 location. In 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. Legal and EEO Statements We will make reasonable accommodations for the known physical or mental limitations of otherwise‑qualified individuals with disabilities or special disabled veterans, unless accommodation would impose an undue hardship on the operation of our business. Please email thebrightside@sunlife.com 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. Job Category Claims – Health & Dental Posting End Date 29/11/2025 #J-18808-Ljbffr Sun Life

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