Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners, and government programs, Sun Life U.S. offers a diverse portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.
Job Description:
Locations:
Must reside in Iowa The Opportunity: The Complaints and Grievances Specialist II is a vital role responsible for investigating and resolving complaints, grievances, and member appeals according to specific regulatory requirements. You will prepare essential documents for State Fair Hearings and coordinate the entire process, interacting daily with market/client contacts and various internal departments. Your role is crucial in ensuring all mandates and turnaround times are met efficiently. How You Will Contribute: Investigate and resolve member complaints and grievances in line with State and Plan guidelines, ensuring thorough research and addressing all issues. Prepare and coordinate State Fair Hearing packets and scheduling reviews. Assemble necessary information for the plan to investigate member appeals and complaints effectively. Monitor shared mailboxes to ensure timely acknowledgment and resolution of requests. Comply with compliance guidelines and resolve directives as needed. Engage with involved providers to gather information and document their perspectives on member concerns. Document all complaints, grievances, and appeals in the tracking system accurately. What You Will Bring: High School Diploma or GED required. 1 year of experience in Complaints & Grievances (C&G) with demonstrated success or 2 years in claims, customer service, or related operational roles. Proficiency in general computer software including Microsoft Excel, Word, and Outlook. Strong verbal, written, and interpersonal communication skills. Exceptional research skills with the ability to identify underlying issues. Calm and focused demeanor in high-pressure environments. Ability to prioritize and manage multiple tasks with tight deadlines. Willingness to work overtime as needed to meet business goals. Salary: We are dedicated to pay transparency and equity, with a competitive salary range for this role nationwide. Your base salary will reflect your unique skills, qualifications, and experience. This position is also eligible for an annual discretionary incentive award based on individual and business performance. Join us in creating a work environment where everyone’s contributions are recognized. We are committed to fostering an inclusive workplace and welcome applications from qualified individuals of all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick leave, medical coverage, life and disability insurance, and retirement planning options. Experience a flexible and collaborative work environment that encourages career growth. We’re honored to be recognized as a top employer in our communities. We will accommodate the known physical or mental limitations of qualified individuals unless it imposes an undue hardship on our operation. For assistance, please email the provided contact. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. Job Category:
Customer Service / Operations Posting End Date:
22/01/2026
Must reside in Iowa The Opportunity: The Complaints and Grievances Specialist II is a vital role responsible for investigating and resolving complaints, grievances, and member appeals according to specific regulatory requirements. You will prepare essential documents for State Fair Hearings and coordinate the entire process, interacting daily with market/client contacts and various internal departments. Your role is crucial in ensuring all mandates and turnaround times are met efficiently. How You Will Contribute: Investigate and resolve member complaints and grievances in line with State and Plan guidelines, ensuring thorough research and addressing all issues. Prepare and coordinate State Fair Hearing packets and scheduling reviews. Assemble necessary information for the plan to investigate member appeals and complaints effectively. Monitor shared mailboxes to ensure timely acknowledgment and resolution of requests. Comply with compliance guidelines and resolve directives as needed. Engage with involved providers to gather information and document their perspectives on member concerns. Document all complaints, grievances, and appeals in the tracking system accurately. What You Will Bring: High School Diploma or GED required. 1 year of experience in Complaints & Grievances (C&G) with demonstrated success or 2 years in claims, customer service, or related operational roles. Proficiency in general computer software including Microsoft Excel, Word, and Outlook. Strong verbal, written, and interpersonal communication skills. Exceptional research skills with the ability to identify underlying issues. Calm and focused demeanor in high-pressure environments. Ability to prioritize and manage multiple tasks with tight deadlines. Willingness to work overtime as needed to meet business goals. Salary: We are dedicated to pay transparency and equity, with a competitive salary range for this role nationwide. Your base salary will reflect your unique skills, qualifications, and experience. This position is also eligible for an annual discretionary incentive award based on individual and business performance. Join us in creating a work environment where everyone’s contributions are recognized. We are committed to fostering an inclusive workplace and welcome applications from qualified individuals of all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick leave, medical coverage, life and disability insurance, and retirement planning options. Experience a flexible and collaborative work environment that encourages career growth. We’re honored to be recognized as a top employer in our communities. We will accommodate the known physical or mental limitations of qualified individuals unless it imposes an undue hardship on our operation. For assistance, please email the provided contact. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. Job Category:
Customer Service / Operations Posting End Date:
22/01/2026