Claims Examiner
2 months ago
About the Role:
We are seeking a highly skilled Claims Assessor to join our team at Global Excel Management Inc. As a Claims Assessor, you will play a critical role in evaluating and enforcing claim benefits and limitations based on a comprehensive understanding of the applicable policy wording.
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:
- 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;
- Available to work daytime schedule. Evenings and weekends may be requested with appropriate notice.
We Offer:
- Competitive wages;
- Bilingual language premium when applicable;
- Group health /dental benefits, RRSP matching;
- Paid training and the opportunity for professional development;
- Growth and advancement opportunities;
- Work life balance;
- Focus on health and wellness initiatives with an excellent EAP program;
- Employee engagement programs that focus on fitness, food and fun.
About Us:
Global Excel Management Inc is a leading provider of insurance solutions. We are committed to delivering exceptional service and value to our clients. If you are a motivated and detail-oriented individual who is passionate about delivering excellent results, we encourage you to apply for this exciting opportunity.
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