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Senior Manager, Insurance and Claims Advocacy
Sun LifeSenior Manager leading Insurance and Claims Advocacy within the Clinical Solutions team at Sun Life U.S. Overseeing complex medical billing, claims resolution, and team development.
Posted 7/29/2026full-timeConnecticut, Maine, Maryland, Massachusetts, Montana • 🇺🇸 United StatesSenior💰 $76,200 - $114,300 per yearWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical billing, claims advocacy, and complex claims resolution, with a strong focus on process improvement and data-driven decision-making. Proven leadership in managing high-performing teams and enhancing member experiences through effective communication and cross-functional collaboration.
Highest-signal resume keywords
Medical Billing ExpertiseClaims Advocacy LeadershipProcess Improvement Using DataCPT/ICD Coding KnowledgeNegotiation Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical BillingClaims ResolutionInsurance Plan AnalysisPayer Claims AdjudicationCPT CodingICD CodingProcess ImprovementData AnalyticsWorkflow OptimizationDocumentation Standards
Soft Skills
Communication SkillsInfluencing StakeholdersNegotiation SkillsTeam LeadershipEscalation Management
Tools & Technologies
SalesforceMS OfficeAI-Enabled ToolsData Platforms
Certifications & Qualifications
Bachelor’s Degree in Healthcare AdministrationAdvanced Degree Preferred
Industry Keywords
Insurance NavigationClaims AdvocacyBenefits EducationCoverage GuidanceSOP AdherenceQuality Standards
About the role
Key responsibilities & impact- Lead and develop a high-performing Insurance and Claims Advocacy team
- Own program strategy, service delivery standards, and key performance indicators across insurance navigation and claims resolution
- Oversee resolution of complex medical billing and insurance issues
- Guide proactive insurance navigation, including benefits education, coverage guidance, and pre-service support
- Build and optimize scalable workflows, leveraging data, technology platforms, and responsible AI-enabled tools
- Ensure accurate, audit-ready documentation and adherence to SOPs, regulations, and quality standards
- Partner cross-functionally to implement improvements, support growth, and elevate the member experience.
Requirements
What you’ll need- 7+ years of experience in medical billing/claims advocacy, complex claims resolution, appeals, coordination of benefits, and insurance plan analysis
- Bachelor’s degree in healthcare administration, business, or related field required; advanced degree and/or relevant certification preferred
- 3+ years of progressive people leadership experience
- Deep knowledge of payer claims adjudication, CPT/ICD coding, and provider billing practices
- Strong negotiation and escalation management skills
- Proven ability to drive process improvement using data/analytics, technology platforms (e.g., Salesforce, MS Office), and responsible AI-enabled tools
- Excellent communication skills and ability to influence cross-functional stakeholders in a fast-paced environment.
Benefits
Comp & perks- Health insurance
- 401(k) employer match
- Paid family, parental and adoption leave
- Generous vacation and sick time
- Company paid life and AD&D insurance
- Disability programs
- Partially paid sabbatical program
- Flexible work arrangements
- Professional development opportunities