Investigator, Fraud Risk Management, Disability Program
Sun Life
full-time
Posted on:
Location Type: Hybrid
Location: Toronto • Canada
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Salary
💰 CA$58,000 - CA$93,000 per year
Job Level
About the role
- Conduct a formal investigation when there is suspected misrepresentation or alternate employment on a Disability claim.
- Engage in phone and email communication with plan sponsors, service providers, disability case managers and other third parties.
- Leverage advanced, open-source search techniques, data analytics tools, and digital investigation frameworks to support organizational objectives and inform strategic decision-making.
- Document findings utilizing technology platforms and formal reports
- Conduct phone interviews with plan members
- Prepare and deliver compelling presentations of investigative findings to internal stakeholders, across various levels.
- Engage in collaborative efforts between other FRM teams and Disability to identify and investigate claim misrepresentation or suspected fraud.
- Maintain accurate documentation of all case notes and findings in an internal case management system.
- Identify fraud trends and support data analytics solutions to mitigate the newly identified risk
- Remain current and up to date on industry trends/education/products/privacy laws/etc.
- Contribute to the ongoing evolvement of the Disability Investigations process.
Requirements
- Experience and formal training in investigations, preferably within insurance or group benefits
- Formal interview training and/or experience
- Exceptional OSINT research skills
- Strong presentation and communication skills with experience utilizing Microsoft Teams
- Experience preparing comprehensive report summaries of investigative findings
- Ability to apply critical thinking and innovative approaches when analyzing investigative findings.
- Knowledge and understanding of contractual language, administration guidelines, and provincial and federal legislation
- Familiarity with medical terminology, an asset
- Knowledge in Disability claims, including short and long-term claims and Group Benefits, an asset.
- As this position is posted in several locations, bilingualism (French, English) is required for Quebec only.
Benefits
- A hybrid organization facilitating a better work/life balance
- Flexible Benefits
- Pension Plan & Stocks Ownership
- Time off
- Being part of a journey in developing the next greatest digital experience
- Agile behaviours, faster decisions and learning as we go.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
investigationsOSINT researchdata analyticsreport writinginterview techniquescritical thinkingcontractual language knowledgemedical terminologyDisability claimsGroup Benefits
Soft Skills
communication skillspresentation skillscollaborationstrategic decision-makingdocumentation accuracyinnovative thinkingattention to detailproblem-solvinginterpersonal skillsbilingualism