Bilingual Claims Examiner

4 weeks ago

Burlington, Canada TEKsystems Full time

Position Title : Bilingual (French/English) Claims Examiner 

Duration:  Permanent

Working Hours:  8:30am - 5pm EST; Monday - Friday

Working Location:  Burlington, ON (Hybrid scheduling - 1x per month in office)

The Disability Claims Examiner I completes the final setup of all new creditor claims. This position is responsible for the complete and final processing of auto adjudicated claims, the initial processing of straightforward claims, and a caseload of total & permanent claims. It also provides administrative support functions to the claims department including maintaining the Claims Centre email box, receiving and distributing facsimiles and contacting policyholders to obtain necessary information.

Role Responsibilities Include but are not limited to:

New Claim Setup 

For each new claim record determine the claimant’s coverage and the necessary claim records for each product Call the claimant to gather the required information necessary to complete the new claim setup Register the claim

Processing of New Claims 

For auto adjudicated claims, based on system parameters and department guidelines accept, pay and close a claim to its recovery date not exceeding 4 months of benefits For straight forward claims, based on system parameters and departmental guidelines accept and pay a claim for 1 month prior to transferring the claim to a Level II or Level III Claims Examiner For Life Express claims, based on system parameters, accept, pay and close a claim. For all other Life Claims transfer to a Level II or Level III Claims Examiner

Ongoing Management of Total & Permanent Claims 

Request and review supplementary medical information for total and permanently disabled claimants Identify claims for re-assessment by a Level II or Level III Claims Examiner where total and permanently disability is in question

Administrative Support for the Claims Department 

Receive and distribute incoming faxes and return mail according to department procedures  Manage emails received through the Claims Centre email box Contact the policyholder to obtain information necessary to confirm coverage Manage the payment communication process for Acadia Vie claims

Requirements:

- Bilingual English/French verbal and written proficiency

- Must be willing to get LOMA licensing within 6-months of starting.

- Minimum 1 year of any type of insurance exposure (claims handling, underwriting, etc.) within home, auto, commercial, travel or disability sector

- Minimum 6 months customer service experience (handling high volume of customer calls)

- Must live close to Burlington office (union requirements and in order to be able to go in 1x month

- High School Diploma

À propos de TEKsystems:

Nous sommes partenaires dans la transformation. Nous aidons les clients à activer des idées et des solutions afin de profiter d’un nouveau monde d’opportunités. Nous sommes une équipe solide de 80 000 personnes, nous travaillons avec plus de 6 000 clients, dont 80 % faisant partie du Fortune 500, partout en Amérique du Nord, en Europe et en Asie. En tant que chefs de file de l’industrie des services technologiques complets, des services aux talents et des applications du monde réel, nous travaillons avec des leaders progressistes pour favoriser le changement. C’est le pouvoir d’un vrai partenariat. TEKsystems est une société du groupe Allegis.

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

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