Bilingual Claims Adjudicator

2 months ago

Montreal, Canada Société Financière Manuvie Full time

Are you looking for unlimited opportunities to develop and succeed? With work that challenges and makes a difference and a flexible and supportive environment, we can help our customers achieve their dreams and aspirations.

To be successful in our claims department you must have a passion for making a difference in our customers' lives You will be a dynamic, positive, customer service focused and creative individual in your work. You will also need to have an aptitude and demonstrated ability to think outside of the box to provide solutions and identify opportunities to improve our processes and customer experience. You are a change-maker, innovative, resourceful and thrive on pushing our company forward with fresh ideas. You are hungry for success and we foster a working environment where you can grow your skills and achieve your goals.

We are currently seeking a Bilingual Claims Adjudicator for a client base across Canada. Product lines include Individual Disability, Critical Illness, Life Waiver of Premium and Long Term Care Policies. The successful candidate must be able/willing to work in a team environment and be motivated to maintain exemplary customer service to our clients.

Responsibilities:
  • Establish and maintain superior customer service to policyholders, agents, marketing centers.
  • Manage ongoing claims by requesting further medical, financial documentation or investigations as required and consult with specialists in all areas.
  • Review claims and underwriting files for proper disclosure of past medical history, exclusions, riders, endorsements; administer policy enhancements, premium waiver and other policy benefits.
  • Make decisions on disability claim eligibility and communicate decisions to stakeholders.
  • Document the claim file to ensure an accurate record of events that transpire in the claim handling.
  • Obtain proper file information and review with policy provisions to verify eligibility.
  • Accurately maintain claim records on system to ensure accuracy of reserve calculations.
What we are looking for:
  • University degree in any discipline or equivalent work experience.
  • 2-3+ years’ experience in adjudicating claims, preferably disability and critical illness.
  • Customer service oriented individual with negotiating skills is essential.
  • Bilingual (French & English) is required - The successful candidate will be required to communicate in English and French in order to support clients from various jurisdictions outside of Quebec.
  • Must have a good working knowledge of medical conditions and terminology, as well as experience in the interpretation and application of financial documentation and fair claims practices.
  • Ability to respond constructively and decisively in high pressure or emotional situations and to respond positively to change.
  • Working knowledge of government legislation and legal precedents, the Insurance Act and/or Quebec Civil Code is an asset.
  • Good working knowledge of the underwriting process.
  • Ability to thrive in a high energy culture.
  • Good analytical skills to evaluate conflicting information from various key sources in order to assess risk in making timely and effective decisions.
  • Proven ability to make decisions and handle pressure.
  • Continuous improvement mindset.
  • Ability to communicate in Cantonese and Mandarin is an asset.
  • You do the right thing - you can effectively communicate client and business impact, both written and verbal; you clearly articulate business needs between technical and non-technical resources as well as present strategy and vision to management.
  • You think big - you are a strategic thinker with the ability to think conceptually beyond day-to-day business realities and to effectively consider downstream impacts.
  • You get it done together - you have a proven track record of building strong relationships and collaboration.
  • You own it - you make it happen, are accountable and you find solutions.
  • You obsess about customers - you have a passion for effortless customer service, and you keep that in the forefront of any initiatives you work on.
  • You share your humanity - you like being part of a collaborative team and are open to diverse perspectives...and of course, you like to have some fun at work.
What can we offer you?
  • A competitive salary and benefits packages.
  • A growth trajectory that extends upward and outward, encouraging you to follow your passions and learn new skills.
  • A focus on growing your career path with us.
  • Flexible work policies and strong work-life balance.
  • Professional development and leadership opportunities.
Our commitment to you
  • Values-first culture - We lead with our Values every day and bring them to life together.
  • Boundless opportunity - We create opportunities to learn and grow at every stage of your career.
  • Continuous innovation - We invite you to help redefine the future of financial services.
  • Delivering the promise of Diversity, Equity and Inclusion - We foster an inclusive workplace where everyone thrives.
  • Championing Corporate Citizenship - We build a business that benefits all stakeholders and has a positive social and environmental impact.
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