Claims Assessor Role
2 days ago
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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