Claim Analyst

You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. Youll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, youll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.

Job Description:

Appraises and approves claims within prescribed approval limits, performs initial review of claims beyond authorized approval limits and submits recommended course of action to Claims Manager.

Specific Accountabilities:

• Appraises and approves death and living benefit claims, both individual and group insurance, within approval limits. Secures Underwriting, Legal and/or Medical input where necessary.
• Appraises claims beyond authorized approval limits, prepares written analysis and recommended course of action and submits to Claims Manager for review and approval.
• Reviews and approves request within disbursement approval limits and initially reviews and submits to Claims Manager for approval those beyond disbursement approval limits.
• Attends to claim inquiries ranging from basic to complex in nature.
• Represents Sun Life in mediation required by the Insurance Commission and Court hearing, as required, involving cases appraised within approval limits.
• Conducts learning sessions for Claims Services Section, as required.
  
  

• Graduate of any four-year course. A medical/allied medical science or legal background would be an advantage.
• Computer literate.
• Very good analytical, judgment, comprehension and conceptual thinking skills
• Detailed-oriented, organized, systematic.
• Patient and interested to read and familiarize self with provisions of the law, medical materials and review and scrutinize various documents.
• Can work independently and is decisive.
• Can work ably under pressure and can multi-task.
• With strong client service orientation and good sense of urgency.
• Possesses effective interpersonal relationship skills and is a team player.
• With above average written and verbal English communication skills.
• Willing to study and pursue required LOMA and ICA courses under Claims Career Development Program.
• With good attendance and punctuality record.