Claims Care Analyst – 1 Year Contract

📋 Description

• Evaluate claims for benefit eligibility by analyzing all pertinent contractual, medical, functional, and occupational documentation in line with established protocols and certificate requirements;

• Effectively oversee an active caseload, ensuring adherence to client service standards, best practice guidelines, KPIs, and turnaround times (TATs);

• Conduct comprehensive documentation of claim assessments and maintain precise records as per company policies and procedures;

• Engage professionally and empathetically, both in written and verbal communication, with stakeholders to provide updates, clarify claim status, and explain decisions;

• Conduct detailed phone interviews with clients or relevant parties to gather information and discuss claim results;

• Identify necessary supporting documents for current and future benefit disbursements and diligently follow up to acquire required information;

• Collaborate with team members, plan sponsors, and other stakeholders to maintain service standards and foster a positive and dynamic work environment;

• Actively participate in departmental projects and continuous improvement initiatives by identifying opportunities for process optimization and adapting to changes;

• Carry out other related tasks as assigned.

⛳️ Requirements

• Post-secondary education or equivalent work experience; a College diploma (DEC) in a relevant field is preferred;

• Professional designations such as FLHC, FLMI, or ALHC are considered advantageous;

• A minimum of 1 year of experience in insurance claims processing, particularly in life, disability, and critical illness insurance;

• Medical knowledge gained through claims assessment, underwriting, or experience in a medical or paramedical profession is beneficial;

• Strong analytical and problem-solving capabilities with keen attention to detail and a commitment to delivering high-quality service;

• High proficiency in English for effective communication with customers and colleagues;

• Strong proficiency in French for communication with customers and/or colleagues in Quebec;

• Ability to conduct sensitive phone interviews and convey decisions with tact;

• Proficiency in Microsoft Office suite (Word, Outlook) and case management software;

• Capacity to multitask and prioritize effectively while meeting various deadlines;

• Professionalism under pressure, with the ability to handle stressful situations and deliver difficult news with empathy;

• A positive attitude, strong team spirit, and adaptability to organizational changes.

🏝️ Benefits

• Flexible work arrangements with monthly financial allocations to enhance your work-life balance;

• Generous starting paid vacation time, along with additional vacation days for each year of service;

• Paid volunteer day to allow you to dedicate time to a cause you are passionate about;

• Paid personal and wellness days to support your overall wellbeing;

• Educational assistance of up to $3,500 a year (subject to manager approval);

• Flexible health and wellness account (in addition to comprehensive drug and dental coverage) to assist with a variety of wellbeing services that are meaningful to you;

• Up to 14% of combined contributions to the RRSP matching program;

• Family-friendly maternity/parental leave and a variety of additional benefits, perks, and programs.