Assess disputed disability claims in accordance with our claims practices and procedures within the services standards set for the organization
Demonstrate an excellent knowledge of group disability insurance and claims management strategies
Take action on all appeals where information gaps are identified throughout the appeal review by obtaining any relevant outstanding information and/or requesting appropriate third party assessments
Provide support to Disability Case Managers on optimal claims decisions, ensuring that all components including the contract, medical, functional and vocational components are considered as part of the overall assessment of the claim decision
Work with Team Managers to identify and close any gaps on case management and decision deficiencies that surface through coaching
Understand key components to claims decisions, including a focus on the need to evaluate and weigh the totality of information and the impact decisions have on clients
Communicate with clients with respect and empathy throughout the appeal process and tactfully deliver final appeal decisions in a sensitive manner
Report on emerging trends so that they can be addressed and where suitable, learnings can be leveraged nationally
Contribute to a dynamic work environment by identifying opportunities to continuously improve processes to better meet our service excellence, quality and financial commitments to our clients

Exceptional decision making and case management skills focused on positive outcomes for plan sponsor, plan member and Sun Life Financial
Critical thinking and stellar client service skills
Strong analytical, organizational and problem solving skills
Solid knowledge of group disability insurance policy and coverage concepts
Excellent listening skills and capacity for empathy
Exceptional verbal and written communication skills
Ability to present case reviews in group settings and collaborate in group discussions
Ability to evaluate and identify key information relevant to each case to present to the Appeal committee
Ability to deliver constructive decisions and feedback in a tactful and sensitive manner
Adaptability, flexibility and strong decision making skills
Bilingualism (French, English, both oral and written) is required for Quebec only for the frequent interactions with English and French-speaking colleagues or internal partners across Canada or worldwide.

Disability Claims Consultant

Key skills