Claims Evaluation Specialist

4 weeks ago


Vaughan, Ontario, Canada People Corporation Full time
Join Our Team as a Claims Evaluation Specialist

We are looking for a dedicated Claims Evaluation Specialist to become a vital part of our BPA team. If you possess a strong background in claims management or have a genuine interest in health and wellness, we invite you to consider this opportunity.

Position Overview:
This role requires you to assess short-term disability claims to establish eligibility and entitlement to benefits, ensuring compliance with medical and contractual guidelines.

Your Responsibilities:
As a Claims Evaluation Specialist, you will:

  • Thoroughly review applications to confirm completeness and gather necessary information for claim assessment.
  • Engage with clients, employers, and healthcare professionals to evaluate claims effectively.
  • Communicate decisions to clients in both verbal and written formats.
  • Manage cases until the client returns to work or refer them for further case management as needed.

Qualifications:
To excel in this role, you should possess:

  • A Bachelor's degree or diploma in a health-related discipline.
  • A minimum of two years of experience in a medical, benefits administration, or claims environment.
  • A solid understanding of medical and mental health conditions and their treatments.
  • The ability to handle confidential medical information with a high degree of discretion.

What We Offer:
At People Corporation, we are committed to fostering an inclusive workplace that reflects the diversity of the communities we serve. We provide:

  • Comprehensive health and dental benefits.
  • A retirement savings plan with company contributions.

About BPA:
BPA, a division of People Corporation, has been dedicated to serving members and beneficiaries in local communities for many years. We strive to deliver an exceptional benefits experience to our members and partners.

We are committed to creating an environment where every employee can thrive and reach their full potential.



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