Group Benefits Claims Manager, Health

1 week ago


Edmonton, Canada RECRUITMENT PARTNERS INC. Full time
Group Benefits Claims Manager, Health and Dental
Our client is looking for a Group Benefits Claims Manager, Health & Dental to join their team in Edmonton. The ideal candidate will bring a wealth of experience in health and dental claims management, combined with proven leadership skills to build a high-performing team. As the Group Benefits Claims Manager you will play a key role in designing and optimizing claims processes, ensuring regulatory compliance, while providing exceptional service to members and other stakeholders, all while exceeding performance metrics.

Your success will be defined by your ability to:
Assist in the evaluation for a new claims adjudication partner Provide input to influence and shape continued development on our new administration system Establish, mentor and lead a new claims management team by fostering a collaborative environment that prioritizes accuracy, efficiency and employee engagement. Design and implement claims processing workflows that ensure timely and compliant handling of all group benefit health and dental claims Provide ongoing training and development opportunities for your team to ensure they are equipped with the necessary skills and knowledge Create a client service culture and embed client engagement by inspiring and motivating the claims team to provide the best claims experience in Canada Conduct regular claim file reviews and performance assessments, to identify and evaluate trends to optimize processes and provide recommendations for technology enhancements. Identify trends and areas for improvement to enhance claims operations and efficiency Possess excellent communication strategies to handle disputes and escalations, working with claimants and Plan Sponsors to find fair resolutions. Your strengths include:
Minimum 3-5 years experience in group benefits claims management, with a proven record of leading and developing a team Minimum 5-7 years group benefits insurance experience with Health and Dental Claims with a deep knowledge of claims processing and regulations. Bachelor’s degree in Human Resources, Business Administration or equivalent Excellent organizational, analytical and interpersonal skills with the ability to manage multiple priorities Strong problem-solving and decision-making abilities with a focus on providing a client focused approach. Excellent communication skills with the ability to convey complex information clearly to various stakeholders. Proficient in MS Office Suite (e.g. Word, Excel, Outlook, and PowerPoint). Experience working with Customer Service Software An insurance designation is considered an asset (LOMA, CEBS (GBA), ICA, etc.) Bilingualism (French and English) is an asset.



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