Claims Review Specialist

2 days ago

Winnipeg, Canada Canada Life Assurance Company Full time

**Job Description**:
We are looking for a **Claims Review Specialist**

Reporting to the Supervisor, Claims Review the Claims Review Specialist is a key member of the Audit and Claim Verification team responsible for completing claim audit processes for a key Canada Life client. The main function of a Claims Review Specialist is to conduct standard claims reviews of providers and members. The Claims Review Specialist will also handle escalations and non-responses from other units within Canada Life.

**What you will do**
- Conduct claims reviews, including assessment of documentation for preselected claims
- Handle referrals from other business units, to investigate concerns identified and follow up on non-responses
- Prepare communications to be sent to members and providers seeking confirmation or clarification of claim information
- Receive, file and action claim review documentation from providers and members
- Identify fraud risk factors of claims reviewed and escalate or refer for further investigation if appropriate

**What you will bring**
- Post-secondary degree/diploma or equivalent work experience
- Education or work experience in an audit/quality/fraud discipline considered an asset
- Experience within a paramedical or other clinic setting considered an asset
- Excellent communication skills, both written and oral
- Ability to manage multiple demands with tight deadlines is necessary.
- Strong technical skills
- Ability to work independently and collaboratively at all levels
- Understanding of Health Claims processes and business knowledge would be an asset.
- Bilingual (French & English) is an asset
- ** Enhanced Security Screening is a requirement of this position.**

**Be your best at Canada Life

Being a part of Canada Life means you have a voice. This is a place where your unique background, perspectives and talents are valued, and shape our future success.

You can be your best here. You’re part of a diverse and inclusive workplace where your career and well-being are championed. You’ll have the opportunity to excel in your way, finding new and better ways to deliver exceptional customer and advisor experiences.

***

Together, as part of a great team, you’ll deliver on our shared purpose to improve the well-being of Canadians. It’s our driving force. Become part of a strong and successful company that’s trusted by millions of Canadians to do the right thing.
- Canada Life serves the financial security needs of more than 13 million people across Canada, with additional operations in Europe and the United States. As members of the Power Financial Corporation group of companies, we’re one of Canada’s leading insurers with interests in life insurance, health insurance, investment and retirement savings. We offer a broad portfolio of financial and benefit plan solutions for individuals, families, businesses and organizations._
- We are committed to providing an inclusive, accessible environment, where all employees and customers feel valued, respected and supported. We are dedicated to building a workforce that reflects the diversity of the communities in which we live, and to creating an environment where every employee _
- has the opportunity to_
- reach their potential._

**_
Canada Life would like to thank all applicants, however only those who qualify for an interview will be contacted_**.

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