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Claims Assessor

2 months ago

Sherbrooke, Quebec, Canada Global Excel Management Inc Full time

Job Summary

As a Claims Assessor at Global Excel Management Inc, you will play a crucial role in evaluating and enforcing claim benefits and limitations based on a comprehensive understanding of the applicable policy wording. This position requires a strong analytical mind and excellent communication skills to ensure that claims are processed efficiently and accurately.

Key Responsibilities

  • Review applicable policy wording to validate claim coverage;
  • Claims are reviewed with precision for compliance with expressed client directives;
  • Establish presence of claim requirements as per policy wording;
  • Research and confirm global claim influences;
  • Contact clients to request missing claim components as required for adjudication;
  • Clarify and explain denials if required;
  • Provide notice of claim decision via formal letter;
  • Ensure creation of appropriate follow-up workflows;
  • Confirm and adjust claim entries as necessary.

Requirements

  • College diploma or equivalent;
  • Knowledge of insurance product benefits and limitations;
  • One to two years of experience in a customer service-related position;
  • Strong decision-making skills and attention to detail;
  • Excellent verbal and written communication;
  • Good organizational skill and ability to prioritize;
  • Proficiency in the Microsoft suite products;
  • Clear and effective communication in English or French (written and verbal); other languages such as Spanish are an asset;
  • Available to work a daytime schedule with occasional evening and weekend requests.

What We Offer

  • Competitive wages;
  • Bilingual language premium when applicable;
  • Group health/dental benefits, RRSP matching;
  • Paid training and the opportunity for professional development;
  • Growth and advancement opportunities;
  • Work-life balance;
  • Focus on health and wellness initiatives with an excellent EAP program;
  • Employee engagement programs that focus on fitness, food, and fun.