Health Claims Specialist

4 weeks ago

Old Toronto, Ontario, Canada iA Financial Group Full time

Department: Claims - Health & Dental Insurance Location: Remote Working Conditions: Flexible Work Environment Status: Permanent, Full-Time

Are you detail-oriented and seeking a fulfilling career in the Insurance sector? As a Health and Dental Claims Specialist, you will be integral in managing health and dental insurance claims with accuracy and efficiency, ensuring compliance with industry regulations and company policies.

Key Responsibilities:
  1. Examine and process health and dental claims, ensuring precision and compliance with contractual agreements.
  2. Authenticate and validate submitted documentation, confirming provider qualifications and implementing necessary controls.
  3. Exhibit proficiency in independently handling various claim types while maintaining high productivity and quality standards.
  4. Engage with members and providers to gather missing information, adhering to established turnaround times.
  5. Identify opportunities for process enhancements and actively contribute to improvements.
  6. Gather essential information required for claim processing, assess reasonable costs, and make informed decisions to approve or deny claims based on contractual terms.
  7. Verify received documents, ensure provider acceptance, and apply appropriate controls based on your authority level.
What You Would Bring to iA:
  1. College diploma (DCS) or equivalent experience.
  2. 2-3 years of relevant professional experience.
  3. Strong analytical skills and sound judgment in decision-making.
  4. Ability to work independently and demonstrate availability.
  5. Commitment to maintaining confidentiality of sensitive information.
What Would Be an Asset but Not Required:
  1. Two years of experience in processing health and dental claims.
  2. Bilingualism in French (both spoken and written communication).
What iA Financial Offers:
  1. A competitive compensation package, including an annual bonus for all permanent employees.
  2. We prioritize a healthy work-life balance, offering Personal Leave Days in addition to vacation.
  3. To promote an active and healthy lifestyle, we provide a comprehensive Wellness plan covering physical activity and wellness expenses.
  4. A medical and dental plan for employees and their dependents, along with a Health Spending Account for uncovered expenses.
  5. A Defined Benefit Pension plan to secure your retirement.
  6. A home office equipment program to create an optimal working environment.
  7. Participation in our Share Purchase Plan with matching contributions from iA.
  8. Your professional development is important to us; we offer an Education Assistance Program to support your career growth.

Our employees are our greatest asset, and we are committed to offering them extensive support.

Company Overview

iA Financial Group combines the strength of a robust company with a human touch, employing over 8,000 individuals. Together, we have earned the trust of more than four million clients and 50,000 advisors who rely on us for their insurance, savings, and wealth management needs.

With over $200 billion in assets and significant investments in technological innovation, we are a key player in the financial services sector in Canada and the United States. Our success stems from our commitment to investing in our employees, one individual at a time. For over 125 years, we have believed that by supporting our workforce and collaborating with reputable industry leaders, we will continue to drive innovation.

At iA, we are dedicated to your success.

Our Commitment to Diversity and Inclusion

At iA Financial Group, we celebrate and support diversity. We strive to maintain 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.

If you require assistance to make the recruitment process more accessible, please reach out to us. A member of our team will be glad to help.

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