Claims Processing Analyst – One-Year Contract

📋 Description

• Evaluate claim eligibility by reviewing all relevant contractual, medical, functional, and professional documentation in line with established procedures and the stipulations of insurance certificates;

• Effectively manage an active caseload while adhering to service standards, best practices, key performance indicators (KPIs), and processing deadlines;

• Maintain comprehensive documentation of claim evaluations and ensure accurate record-keeping in compliance with company policies and procedures;

• Communicate with professionalism and empathy, both verbally and in writing, to provide updates, clarify claim statuses, and elucidate decisions;

• Conduct thorough telephone interviews with clients or relevant stakeholders to gather necessary information and discuss claim results;

• Identify necessary supporting documents for current and future payments, and follow up as needed to acquire requested information;

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

• Actively engage in departmental projects and continuous improvement initiatives by recognizing opportunities for process optimization and embracing change;

• Perform other related tasks as required.

⛳️ Requirements

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

• Professional designations such as FLHC, FLMI, or ALHC are regarded as assets;

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

• Medical knowledge acquired through claims management, underwriting/pricing, or a medical/paramedical profession is beneficial;

• Strong analytical and problem-solving abilities, keen attention to detail, and a dedication to high-quality service;

• Proficient English communication skills for interactions with clients and colleagues;

• Strong French communication skills to engage with clients and/or colleagues in Quebec;

• Capability to conduct sensitive telephone interviews and convey decisions with tact;

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

• Ability to juggle multiple priorities concurrently while meeting various deadlines;

• Professional demeanor under pressure, with the capacity to manage stressful situations and deliver difficult decisions with empathy;

• Positive outlook, strong team spirit, and adaptability to organizational change.

🏝️ Benefits

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

• Generous initial paid time off, along with additional days off for each year of service;

• One paid volunteer day to allow you to contribute to a cause you care about;

• Paid personal and wellness days to promote your overall well-being;

• Education assistance up to $3,500 per year (subject to manager approval);

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

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

• Maternity/parental leave options for families;

• Additional benefits and programs available.