Overpayment Recovery Analyst

2 weeks ago

Wellesley Hills, United States Sun Life Full time

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. You'll 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, you'll 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.

At Sun Life, we look for optimistic people who want to make life brighter for our Clients. We understand the value of diverse cultures, perspectives, and identities, and want you to bring your full and authentic self to work. Every day, you’ll be empowered and challenged by working with dynamic colleagues to find new and innovative ways to make Sun Life the best benefits company in America.

**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

**Life is brighter when you work at Sun Life**
- Excellent benefits and wellness programs to support the three pillars of your well-being - mental, physical and financial - including generous vacation and sick time, market-leading paid family, parental and adoption leave, a partially-paid sabbatical program, medical plans, company paid life and AD&D insurance as well as disability programs and more
- Retirement and Stock Purchase programs to help build and enhance your future financial security including a 401(k) plan with an employer-paid match as well as an employer-funded retirement account
- A flexible work environment with a friendly, caring, collaborative and inclusive culture
- Great Place to Work® Certified in Canada and the U.S.
- Named as a “Top 10” employer by the Boston Globe's “Top Places to Work” two years running

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.

**If you are a California resident,** the salary range for this position is:

- Southern region: $74,600-$111,900 annually
- Central region: $78,700-$118,100 annually
- Northern region: $84,200-$126,300 annually

**If you are a Colorado resident**, the salary range for this position is $71,200-$106,800 annually.

**If you are a New York resident**, the salary range for this position is $84,200-$126,300 annually.

**If you are Washington resident**, the salary range for this position is $78,700-$118,100 annually.

We consider various factors in determining actual pay including your skills, qualifications, and experience. In addition to salary, this position is eligible for incentive awards based on individual and business performance as well as a broad range of competitive benefits.

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