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Dispute Resolution Specialist

2 months ago

Toronto, Canada MSH Americas - Diot-Siaci Group Full time

It's fun to work in a company where passion meets profession, and every team member is not just an employee but a dedicated enthusiast, making the work journey truly enjoyable and fulfilling

About Us:

We are seeking ambitious individuals who share our values and our passion for making a positive impact on people's lives around the world. If you are looking for a career that challenges and inspires you, you've come to the right place.

About You:

As a Dispute Resolution Specialist, your role revolves around swiftly investigating and resolving claims issues, complaints, disputes, and queries. Upholding established quality service standards and delivering advanced client care are integral aspects of your position. This requires adhering to policy-driven response deadlines for emails and calls while maintaining transparent and open communication with clients.

In this role, you’ll get to experience:

Investigation and Research:

  • Investigate and research escalated complaints, issues, and queries from various sources, including insureds, human resource administrators, clients, call centers, adjudicators, and account management.
  • Document all disputes meticulously, following the established dispute resolution process, and maintain and update the complaint (reclamation) workflow.

Thorough Initial Investigation:

  • Conduct a comprehensive initial investigation for each dispute to determine their validity and root causes.
  • Review corrective measures with the VP of Claims before implementation.

Collaborative Resolution:

  • Collaborate with internal teams (adjudicators, call center, QA, training, supervisors, account management, accounting) to propose recommended resolutions for each dispute, ensuring alignment with service level targets.
  • Ensure timely communication by providing updates to both internal and external stakeholders throughout the dispute resolution process.
  • Take charge of handling escalations from start to finish.
  • Close the loop with the member, ensuring not only resolution but also maintaining effective communication channels throughout the process.

Feedback and Assistance:

  • Attend meetings as required with the supervisor or team leads.

What you bring:

  • Completion of Post-Secondary education in Business, Insurance, Legal Studies, or equivalent work experience.
  • 1-3 years of proven experience in claims processing or dispute resolution within the insurance industry.
  • Proficient in utilizing internet and email platforms and intermediate proficiency in Microsoft Office applications.
  • Familiarity with insurance policies, regulations, and industry standards.
  • Must be fluent in English and French

What’s in it for you:

  • Hybrid work environment
  • Excellent health benefits
  • Employee assistance program
  • Wellness account
  • RRSP matching
  • Minimum 3 weeks’ vacation
  • Generous amount of sick and flex days
  • Tuition reimbursement program
  • Opportunities to learn new skills, grow, and move into different roles
  • A work environment that embraces diversity and promotes inclusivity.
  • Supportive leadership prioritizes your success and cares about your well-being.
  • A growth trajectory designed to expand vertically and horizontally, providing opportunities to pursue your passions and acquire new skills.

Additional Notes

  • The hours for this position are 9 am-5 pm Monday to Friday
  • A laptop will be provided

MSH is an Equal Opportunity Employer

MSH Americas is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other protected status under applicable law. We encourage and welcome applicants from all backgrounds to apply for our open positions. Removing obstacles to offer fair access to jobs is our top priority. When a candidate asks for reasonable accommodation throughout the application process, a Human Resources professional will assist them. The information provided during the accommodation request process will be handled, saved, and utilized by the laws that apply to it and the rules of MSH International.