Claims Examiner

1 week ago

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

We are seeking a highly skilled Claims Examiner to join our team at MSH Americas - Diot-Siaci Group. As a Claims Examiner, you will 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.
  • Other related duties as assigned.
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.
  • Supportive leadership prioritizes your success and cares about your well-being.
  • A growth trajectory that is designed to expand both vertically and horizontally, providing you with opportunities to pursue your passions and acquire new skills.

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