Claims Assessor Role

2 days ago


Sherbrooke, Quebec, Canada Global Excel Management Inc Full time

Job Summary

We are seeking a Claims Assessor to join our team at Global Excel Management Inc. As a Claims Assessor, you will play a crucial role in evaluating and enforcing claim benefits and limitations based on a comprehensive understanding of the applicable policy wording.

About the Role

This is a daytime schedule position with possible evening and weekend work required. You will be responsible for qualifying claims/bills for payment, reviewing them for customer service, and making direct client contact when necessary.

Your Key Responsibilities

  • Review applicable policy wording to validate claim coverage;
  • Claims are reviewed with precision for compliance with expressed client directives (as applicable)
  • Establish presence of claim requirements as per policy wording (i.e., proof of payment and authenticity of bills/claims)
  • Research and confirm global claim influences (i.e., travel advisories)
  • Contact client to request missing claim components as required for adjudication;
  • Clarify and explain denials if required;
  • Provide notice of claim decision via email, phone or formal letter;
  • Ensure creation of appropriate follow-up workflows;
  • Confirm and adjust (if required) claim entries.

Requirements

To be successful in this role, you will need:

  • 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.

What We Offer

We offer a competitive salary range of $60,000 - $80,000 per year, depending on experience, plus opportunities for growth and advancement. Additionally, you will receive:

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

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