Operations Analyst

Job Description Sun Life U.S. is one of the largest providers of employee and government benefits, offering dental, vision, disability, absence management, life, supplemental health, medical stop‑loss insurance, and healthcare navigation services to approximately 50 million Americans. The company has more than 6,400 employees nationwide. Location Hybrid work model: flexible virtual work and in‑office collaboration, with a minimum of two office days per week. Responsibilities Ensure new and renewal contracts match underwriting approvals and TPA work‑arounds for specific dates, claim basis, rates, number of lives, fees, address, monthly accommodation, terminal liability, lasers, retirees, transplant vendor endorsement, and brokers. Customize contracts according to TPA work‑arounds and sales details, including sub‑accounts for multiple accounts with different claim basis, rates, and names. Set up the claims system (CMS) and Compass for billing, verify deductibles, claim basis, fees, lasers, retirees coverage, and enter all contacts for policy, payee, and banking information. Verify CMS information for accuracy, including deductible data, claim basis, fees, lasers, retirees status, payee and banking information, and update contacts as needed. Review previous year’s contracts for rate tier changes (e.g., 2 tiers to 4 tiers). Update rate tiers and Health Navigator additions in Compass when necessary. Administer contract revisions per underwriting notifications. Perform other duties as assigned. Qualifications Bachelor’s degree or equivalent work experience. 2–3 years of experience in the financial services industry. At least 2 years’ experience in Stop Loss claims and/or underwriting (preferred). Knowledge of Stop Loss Insurance products and processes (preferred). Ability to interpret client plan documents and Stop Loss policies (preferred). Creative problem‑solving skills for complex or non‑routine issues. Strong written and verbal communication. Ability to coach, develop, and motivate team members to achieve departmental and SLF goals. Negotiation, analytical, and problem‑solving abilities. Ability to build professional relationships across organizational levels and with external TPAs and customers. Commitment to mutual respect, cooperation, information sharing, and service delivery. Strong PC proficiency. Deadline‑oriented and goal‑focused. Knowledge of company computer systems and products (strong plus). Salary $49,200 – $66,400 Salary range is competitive nationwide and determined by skills, qualifications, experience, education, and geography. The position includes a discretionary annual incentive award. EEO Statement Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local laws and 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. Reasonable Accommodation We will make reasonable accommodations for the known physical or mental limitations of otherwise‑qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose undue hardship. Please email View email address on click.appcast.io to request an accommodation. California Applicants For applicants residing in California, please read our employee California Privacy Policy and Notice. Additional Information We do not require or administer lie detector tests as a condition of employment or continued employment. #J-18808-Ljbffr Sun Life