Claims Processing Specialist

This is a fully remote position, open to applicants in Canada.

📋 Description

• Process financial support claims for clients and employers, ensuring compliance with contractual and legislative standards.

• Conduct quality assurance for claims and invoices handled by Service Provider personnel.

• Address inquiries from staff concerning claims and administrative matters.

• Communicate issues related to ineligible claims following established protocols.

• Provide support and guidance to staff on claims processing requirements.

• Monitor emerging trends in claims assessment and report them to the Claims Manager.

• Adjust activities in response to evolving requirements and business needs.

• Appropriately manage discrepancies and escalate issues when necessary.

• Direct staff to the relevant team members or internal partners.

• Identify and manage organizational risks, escalating any non-standard, high-risk transactions or activities.

• Develop an understanding of WCG contracts, guidelines, policies, and processes.

• Perform standard and ad hoc data entry tasks.

• Utilize WCG’s Case Management System along with other systems and databases efficiently.

⛳️ Requirements

• Strong background in auditing and experience in data entry.

• At least 2-3 years of experience in a similar role within a service-oriented organization.

• Proficiency in MS Office, particularly Excel and Word.

• Detail-oriented with exceptional accuracy.

• Ability to adapt to changing circumstances.

• Understanding of the requirements in a highly confidential environment.

• Capability to maintain composure in challenging and high-pressure situations.

• Results-driven with a creative approach to generating ideas and solving problems.

• Excellent organizational and time management skills.

• Able to function in a fast-paced environment with a variable workload.

• Bilingual in English and French is preferred.

• Knowledge of the Employment Services industry is preferred.

🏝️ Benefits

• Comprehensive and flexible health and dental benefits.

• RRSP matching program of 2.5% of base earnings.

• Continuous learning and development opportunities.

• Generous time-off policies that encourage work/life balance.

• Remote work from a Canadian home office.

• A diverse and inclusive workplace.

• Accessible, barrier-free recruitment and selection process.

• Opportunity to engage in work that makes a positive impact.