Claims Clerk

Job Title: Claims Clerk

Department: Claims Department

Job ID: CLM03

Location: Edmonton, AB

Position Type: Permanent, Full-Time, In-office

About Employee Benefit Funds Administration Ltd.

Employee Benefit Funds Administration Ltd. (EBFA) is a non-profit organization established in 1993 to administer the pension, health & welfare, and education trust funds for IBEW Local Union 424 members. EBFA provides accurate, timely, and professional administrative services for three union trust funds and supports the governance and operations of five Boards and their committees. Guided by a Board of Directors representing both union and employers, EBFA is committed to delivering exceptional service that underpins the financial security, health, and education of plan members and their families.

Position Overview

We are seeking a detail-oriented Claims Clerk with high emotional intelligence to join our dynamic Claims team. As the first point of contact for plan members, service providers, and the general public, you will play a crucial role in delivering exceptional customer service while ensuring accurate adjudication and processing of claims.

This position requires a strong focus on accuracy, communication, and collaboration. Your ability to analyze information, apply policy guidelines, and respond professionally to inquires will be the key to your success in this role.

What You'll Do:

Core Responsibilities:

• Review claim forms and supporting documentation for completeness and accuracy
• Apply policy guidelines and coverage rules to adjudicate claims
• Approve or deny claims based on terms and conditions of coverage
• Communicate with plan members and healthcare providers for additional details or clarification
• Accurately input and update claim information in the internal database
• Verify plan member eligibility and coverage details
• Maintain up-to-date knowledge of insurance policies, procedures, and regulations
• Greet and assist all visitor including plan members and service providers
• Respond to claim-related inquires via phone, email, or in-person
• Track and report daily departmental statistics
• Periodically assist with uploading claims for processing

What You Bring:

• Post-secondary education, preferably in an Office Administration program
• Previous experience in claims processing or a related field is an asset
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook) and Adobe Acrobat
• Strong interpersonal and customer service skills with the ability to quickly adapt
• Excellent verbal and written communication skills, with the ability to draft professional correspondence
• Demonstrated ability to handle sensitive and confidential information in compliance with company policies and privacy legislation
• Capable of working independently and as part of a team
• Positive attitude with a willingness to learn new systems and processes
• Preference given to candidates with IFEBP Foundation Courses in Benefits or CEBS designation
• Successful completion of a criminal background check is required

Why Work at EBFA?

• Compensation starting at $24.24 per hour
• A permanent, full-time position (39-hour work week during regular business hours)
• Employer-paid Defined Benefit Pension plan.
• Employer-paid Health and Welfare Benefits.
• Generous paid vacation plus two personal days
• Tuition reimbursement for approved educational development

Apply Today

If you would like to join our team, please submit your resume and cover letter highlighting your relevant experience. When submitting your documents, please upload them individually as a PDF or Word document using the naming convention: Last Name, First Name – Document Type.

Please note shortlisted candidates will be required to provide verification of the educational and professional credentials listed on their resume.

We thank all applicants for their interest; however, only those selected for an interview will be contacted. This position will remain open until a suitable candidate is found.

Job Types: Full-time, Permanent

Pay: From $24.24 per hour

Expected hours: 39 per week

Work Location: In person