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Claims Examiner

2 months ago

Toronto, Ontario, Canada MSH Americas - Diot-Siaci Group Full time
About Us

At MSH Americas - Diot-Siaci Group, we're dedicated to making a positive impact on people's lives around the world. We're seeking ambitious individuals who share our values and passion for delivering exceptional customer service.

About the Role

We're looking for an experienced Claims Examiner who can handle a large case load, multitask, and meet tight deadlines. As a Claims Examiner, you'll be responsible for processing a variety of different claims and communicating these decisions to providers, members, and clients.

Key Responsibilities
  • Process travel insurance claims for medical, trip cancellation/interruption, baggage, dental, and vision claims up to the designated limit.
  • Adjudicate claims according to various benefit policies.
  • Handle both inbound and outbound calls, and complaints, and provide excellent customer service for claims matters both in person and via written correspondence.
  • Work closely with claimants, providers, agents, brokers, other insurance carriers, or their representatives.
  • Work closely with other departments within the company on a day-to-day basis.
  • Maintain accurate documentation on all claim files.
  • Adjust reserves following the insurer's guidelines.
  • Present cases and participate in discussions during file reviews and appeals.
  • Ensure all work complies with the PIPEDA and HIPAA.
  • Support department initiatives and objectives.
  • Provide guidance and mentorship to peers.
Requirements
  • High school diploma or University Degree or equivalent.
  • Minimum 2-3 years of relevant travel insurance or medical insurance claims processing experience.
  • Bilingual: English/French is required.
  • Strong analytical and problem-solving skills.
  • High level of proficiency in Microsoft Office suites.
  • Superior verbal and written communication skills in English and/or French.
  • Strong time management and organizational skills.
  • Must successfully apply for Alberta Adjuster License within one month of hire.
What We Offer
  • Hybrid work environment.
  • Excellent health benefits.
  • Employee assistance program.
  • Wellness account.
  • RRSP matching.
  • Minimum 3 weeks' vacation.
  • Generous allowances for sick and flex days.
  • Tuition reimbursement program.
  • Opportunities to learn new skills, grow, and move into different roles.
  • A work environment that embraces diversity and promotes inclusivity.