Senior Claims Analyst
2 weeks ago
Job Summary
The Senior Claims Analyst provides critical support to the Claims Department, focusing on process documentation, escalations, complex inquiries, staff training, and technical assistance. This role is responsible for timely and accurate handling of high-impact claims and assists the department with claims processing or clerical work during fluctuations or team member absences.
Key Responsibilities
- Research and advise on claims-related items, including timely escalations
- Provide technical support to the team
- Interact with internal and external stakeholders to complete day-to-day tasks
- Oversee and assist with internal and external audits
- Process stop-payments, system adjustments, overpayments, and overrides
- Review and approval of High Dollar Claims
- Process and adjudicate claims for assigned clients
- Perform tasks in accordance with service level agreements, client demands, and regulatory requirements
- Process various administrative and claims-related inquiries and ad-hoc tasks
- Assist with Analyst or Clerk work as required
- Keep the Supervisor(s) informed of department concerns and/or obstacles
- Act as backup to other senior roles within the department
- Participate in special projects, including continuous improvement initiatives
- Test and evaluate system changes
- Assist with new client implementations
- Develop and maintain standardized documentation tools and methods
- Develop, prepare, and maintain templates, educational aids, and materials
- Coordinate and provide employee training and feedback
- Train staff on using tools developed by the department and maintain procedure guides
- Facilitate learning through various delivery methods, including classroom training, virtual training, or on-the-job coaching
- Develop and apply assessment tools to measure training effectiveness
- Proactively identify topics to be addressed or areas in need of additional instruction
Requirements
- Post-secondary diploma in a related field, such as business administration or equivalent training acquired from a combination of relevant work experience and education
- 2-3 years of work experience in a field related to employee benefits or equivalent training
- Comfortable working independently with minimal supervision
- Proficiency in MS Office products with advanced knowledge of Excel and Word
- Demonstrate good judgment, reliability, and professionalism in a fast-paced environment
- Superior interpersonal skills, excellent written and verbal communication skills
- Strong initiative, planning, and problem-solving skills, attention to detail, organizational, time management, and prioritizing skills
- Comfortable dealing with company personnel at various levels
- Sound judgment and critical thinking skills
- The ability to use tact, discretion, and maintain information in the strictest of confidence
- Bilingual, written and oral (English and French), is considered an asset
About Cowan Insurance Group
Proudly independent and Canadian-owned, Cowan Insurance Group has been a true market leader in the insurance industry since 1927. With an extensive range of product offerings and integrated commercial and personal insurance, group benefits, and wealth management solutions, we provide our clients with outstanding customized, comprehensive insurance and risk management professional advice and placement.
Recognized as one of Canada's Most Admired Cultures and a Canada's Best Managed Companies Platinum Club Member, Cowan Insurance Group's award-winning client-centric approach emphasizes innovation, excellence, and collaboration.
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