Health Insurance Analyst

5 months ago

Toronto, Canada Beneva Full time

Official Internal Job Title:
Health Insurance Analyst

Status:
Regular

Job Description:
Reporting to the Director, the Group Health and Dental Insurance Analyst analyzes specific problems and situations related to the management of Pan-Canadian Group Health and Dental Insurance plans; develops strategies intended to respond to our customers needs; provides the necessary support and guidance to the administration of group insurance plans and to adapt our claims procedures accordingly; has a strong knowledge of the Pan-Canadian group insurance market and of the different Provincial healthcare programs related to the Health and Dental sectors; participates with our Toronto office team in meetings with clients, group or third party administrators, suppliers, to represent the Company.

JOB DUTIES- To analyze problems and situations related to Group Health and Dental insurance and to propose and develop solutions based on solid information gathering and that are adapted to the client needs.- To provide to our Health and Dental claims processing team all the necessary information about health and dental public plans in each provinces and territories.- To participate in the revision of documents, intended to members, group administrators, suppliers, third party administrators.- To put in place mechanisms allowing to collect complaints and comments from customers or third party administrators; to identify customers or third party administrators’ needs; to propose the necessary changes or modifications.- To identify market requirements and how the Company can deliver on these requirements.- To work closely with our providers (ESI, Claim Secure, etc.) to make sure processes are being followed.- To provide support to our Toronto Customer Service team and to our Claims processing team on the resolution of claim issues.- To provide input regarding tools, systems and information available to our Toronto Customer Service.- To represent the Company at occasional Finalist Presentation and quarterly review meetings for large clients.- To provide or request, by telephone, interviews or by writing, information pertaining to departmental activities (suppliers, external clients, pharmacies, TPA’s, etc.).- To work with the Systems Development team and analysts, running interactive systems tests and participating in the acceptance of functional requirements.- To participate in group work organized within the Claims Processing Department.- To perform any other required tasks or duties.

RESPONSIBILITIES- To find effective solutions based on solid information gathering, followed by rigorous and logical analysis of such.- To effectively contact and deal with people, displaying an open communication style and honesty, while respecting the opinions of others.- To constantly strive for quality and excellence in the work methods, services provided and products being sold.- To be aware of early-warning signs of changes to come.- To ask appropriate questions that will help bring about the best possible results in the most cost-effective fashion.- To be able to work unsupervised, to follow independent lines and to carry out projects or activities self-sufficiently.- To back up ideas, projects, and goals with concrete actions.- To decide which messages to convey using appropriate language, drafted using clear and precise language.- To share ideas and projects for change, while ensuring that these are carried out.

REQUIRED SKILLS AND KNOWLEDGE

Education- Bachelor’s degree in Business Administration or in a relevant discipline

Experience- 7 years of experience in group health and dental insurance in the Canadian market

Requirements- Strong verbal skills.- Excellent command of spoken and written English.- Be familiar with software such as Excel, Word and Power Point.- Strong knowledge of the Provincial Healthcare Programs.- Functional French.

LI-ENG

LI-HYBRID
- Beneva is an equal opportunity employer, so we encourage all Women, persons with disabilities, Indigenous people as well as visible and ethnic minorities to apply._
- Purpose :_ True to its purpose, Beneva places people at the heart of its actions and contributes to the well-being of the community. It accompanies its clients in all stages of their lives, both for their insurance and for their financial services._

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