Bilingual Claims Care Representative

Role Overview

• Effectively manages case/claims assignments and responds to inquiries from claimants regarding claim status and/or requests for claim forms.
• Manages the initial stages of screening claims.
• Applies an excellent understanding of certificate and policy provisions.
• Sets-up claims, including verifying policyholder information, policy effective date, premium status, and verification of claim eligibility and including ensuring appropriate claim forms are delivered to claimant.
• Communicates with key stakeholders including claimant, business partners, plan sponsors, physician, employers, verbally and/or in writing. Handles a variety of inquiries varying in complexity.
• Ensures compliance with Quality Assurance requirements and procedures
• Maintains compliance all KPI’s, standards, controls, policies, and practices as an active participant in the Company’s Information Privacy and Security Program.
• Perform other duties as assigned.

Requirements

• Post-Secondary Education preferred or equivalent work experience.
• This role requires strong French and English communication skills because it involves regular, direct interaction with French
• and English-speaking customers and colleagues.
• Ability to perform tasks simultaneously within deadlines.
• Strong attention to detail.
• Fundamental knowledge of computers and keyboarding skills.
• Strong communication skills (strong telephone and interpersonal skills).
• Ability to make decisions with resource guidance
• Strong commitment to quality of work
• Exceptional customer service.
• Knowledge of insurance practices and principles are assets.
• Knowledge of medical terminology, policy provisions, and provincial regulations are assets.
• FLHC, FLMI or ALHC designation are an asset.

Benefits

• Flexible work arrangements with monthly financial allocations to support your work-life balance;
• Generous starting paid vacation time, plus additional vacation days for every year of service;
• Paid volunteer day so you can dedicate time to a cause you are passionate about;
• Paid personal and wellness days to support your total wellbeing;
• Educational assistance of up to $3,500 a year (with approval from your manager);
• Flexible health and wellness account (in addition to comprehensive drug and dental coverage) to help pay for a wide range 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,
• Many more benefits, perks and programs.