About This Role
Caring for a large caseload of claims and meeting tight deadlines is the core of this role, which suits an experienced Claims Examiner who thrives in a fast-paced environment. You will provide excellent customer service and develop an in-depth understanding of various policies to assess claims and inquiries accurately.
Responsibilities
- Process travel insurance claims for medical, trip cancellation/interruption, baggage, dental, and vision claims up to the designated limit
- Adjudicate claims according to various benefit policies
- Handle both inbound and outbound calls, and complaints, and provide excellent customer service for claims matters both in person and via written correspondence
- Work closely with claimants, providers, agents, brokers, other insurance carriers, or their representatives
- Work closely with other departments within the company on a day-to-day basis
- Maintain accurate documentation on all claim files
- Adjust reserves following the insurer’s guidelines
- Present cases and participate in discussions during file reviews and appeals
- Ensure all work complies with the PIPEDA and HIPAA
- Support department initiatives and objectives
- Provide guidance and mentorship to peers
- Other related duties as assigned
Requirements
- High school diploma or University Degree or equivalent
- Minimum 2-3 years of relevant travel insurance or medical insurance claims processing experience
- Bilingual: English/French is required
- Strong analytical and problem-solving skills
- High level of proficiency in Microsoft Office suites
- Superior verbal and written communication skills in English and/or French
- Strong time management and organizational skills
- Must successfully apply for Alberta Adjuster License within one month of hire
Nice to have:
- Snowbird, expatriate insurance, TPA experience
- Experience in handling Canadian and US medical invoices/claims
- Dispute resolutions experience
- GHIP recovery/coordination of benefits/subrogation
- Solid Team Player
Benefits
- Variable Bonus
- Comprehensive health benefits
- Employee assistance program
- Wellness spending account
- RRSP matching
- Minimum 3 weeks vacation (plus generous sick and flex days)
- Tuition reimbursement
- Real opportunities for growth and skill development
- Inclusive, diverse workplace culture
- Leadership that genuinely cares about your success and well-being
