Medical Claims Processor

Are you analytical, detail-oriented, and motivated by the opportunity to support clients when it matters most? As a Claims Analyst with our Special Markets Claims team, you will assess lower-risk and non-core claims in accordance with policy provisions, internal guidelines, and service standards. This role offers an excellent opportunity to develop strong foundational claims expertise in policy interpretation, file management, decision-making, and customer communication. Depending on your experience and training, you may also adjudicate limited-risk products and a defined portion of a core product. You will work closely with Claims Specialists, contribute to the team’s day-to-day operations, and progressively build the knowledge and capabilities required to advance your career within claims. As a Claims Analyst , you’ll be at the core of our mission. Adjudicate non-core and lower-risk Special Markets claims within assigned authority levels. Assess eligibility and entitlement based on policy provisions, medical information, and supporting documentation. Request, review, and analyze the documentation required to support fair and objective claim decisions. Communicate claim decisions clearly, professionally, and respectfully to claimants, brokers, third-party administrators, policyholders, benefit administrators, and internal partners. Maintain accurate, timely, and objective claim file documentation in accordance with regulatory, privacy, and audit requirements. Identify and escal... complex, sensitive, or higher-risk claims to the appropriate senior-level resource. Depending on business needs, experience, and training, assist with a defined portion of a core product within an established scope and authority. Develop and maintain positive working relationships with clients and business partners while ensuring compliance with policy provisions and privacy requirements. Participate in meetings and discussions related to claims-handling practices and service delivery. Build and maintain your knowledge of Special Markets products, policies, procedures, and industry practices. Participate in training, coaching, and knowledge-sharing activities. Apply feedback to continuously improve decision-making, communication, and claim quality. Has experience in the insurance industry or in a related claims environment; Can interpret policy provisions and supporting documentation effectively; Demonstrates strong customer service, verbal communication, and written communication skills; Is committed to continuous learning and receptive to coaching and feedback; Has foundational knowledge of group life, health, accident, and sickness plans, which would be considered an asset; Bilingualism in English and French would be considered a strong asset, as the preferred candidate will be expected to support a significant volume of both English and French claims on a regular basis. AI is in everyone’s hands, empowering you to increase your personal effectiveness while supporting the organization’s growth; Flexible group insurance, competitive pension plan, stock purchase plan, vacation and wellness/personal development days, telemedicine, employee and family assistance program, ergonomic furniture program, performance bonus, discounts on iA products, and much more The typical hiring range for this position is between CAD $50,159 and CAD $65,833 per year; the base salary offered may vary depending on knowledge, skills, years of experience, and internal equity related to the role. Posting End Date With over $200 billion in assets and half a billion invested in technological innovation, we’re a key player in the financial services industry in Canada and the United States. Because, for over 125 years, we have believed that it’s by supporting our employees and surrounding ourselves with the most reputable leaders in the industry, we will continue to innovate. iA Financial group includes the following entities: iA Services financiers, iA assurance auto et habitation, iA Gestion privée de patrimoine, PPI Management, Investia, iA Gestion de placements, Prysm, iA Clarington, Michel Rhéaume et associés, Garanties Nationales, WGI Manufacturing, WGI Service Plan Division, Lubrico, iA Financement auto Our Commitment to Diversity and Inclusion At iA Financial Group, we support and celebrate diversity. We strive to provide a workplace that is recognized as inclusive for all, regardless of ethnic origin, nationality, language, religious beliefs, gender, sexual orientation, age, marital status, family situation, or physical or mental disability. Please note that if you need help or assistance to make the recruitment process more accessible for you, please Contact us here.