Bilingual (Fr/En) Claims Review Specialist

22 hours ago

Winnipeg, Canada Canada Life Full time

Join to apply for the Bilingual (Fr/En) Claims Review Specialist role at Canada Life Permanent Full Time We are looking for a Claims Review Specialist. Reporting to the Supervisor, Claims Review the Claims Review Specialist is a key member of the Audit and Claim Verification team responsible for completing claim audit processes for a key Canada Life client. The main function of a Claims Review Specialist is to conduct standard claims reviews of providers and members. The Claims Review Specialist will also handle escalations and non-responses from other units within Canada Life. What you will do Conduct claims reviews, including assessment of documentation for preselected claims Handle referrals from other business units, investigate concerns identified and follow up on non-responses Prepare communications to be sent to members and providers seeking confirmation or clarification of claim information Receive, file and action claim review documentation from providers and members Identify fraud risk factors of claims reviewed and upscale or refer for further investigation if appropriate What you will bring Bilingualism (fluent in French and English) required, as the position will regularly serve our clients with English and French‑speaking need Post‑secondary degree/diploma or equivalent work experience Education or work experience in an audit/quality/fraud discipline considered an asset Experience within a paramedical or other clinic setting considered an asset Excellent communication skills, both written and oral Ability to manage multiple demands with tight deadlines is necessary Strong technical skills including Outlook, Excel, Teams Ability to work independently and collaboratively at all levels Understanding of Health and/or Dental Claims processes and business knowledge would be an asset Reliability Status Security Clearance – this can only be completed with candidates who receive an offer of employment. This is a personal security status that is required as a condition of employment before an employee can gain access to Protected B information, assets or work sites as outlined by the Government of Canada website. The cost of submitting these checks will be covered by Canada Life Location: Winnipeg head office. Salary range: $43,400 − $58,600 annually (base salary only). Other variable compensation components may apply. Recruiter will discuss additional details of total rewards program. Career opportunities: open a minimum of 5 business days from posting date; closing dates vary; applications reviewed on rolling basis. We are committed to providing an inclusive, accessible environment. To request a reasonable accommodation in the application process, contact talentacquisitioncanada@canadalife.com. #J-18808-Ljbffr

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