Claims Assessor(Non-Medical)

1 month ago

Sherbrooke, Canada Global Excel Management Inc Full time

Job Description

As a Non-Medical Claims Assessor, you will evaluate and enforce claim benefits and limitations based on a comprehensive understanding of the applicable policy wording. The claims assessor is responsible for qualifying a claim/bill for payment and reviewed for customer service and may require direct client contact. 

What does your typical day look like?

Review applicable policy wording to validate claim coverage; Claims are reviewed with precision for compliance with expressed client directives (as applicable) Establish presence of claim requirements as per policy wording (i.e.: proof of payment and authenticity of bills/claims) Research and confirm global claim influences (i.e. travel advisories) Contact client to request missing claim components as required for adjudication; Clarify and explain denials if required; Provide notice of claim decision via email, phone or formal letter; Ensure creation of appropriate follow up workflows; Confirm and adjust (if required) claim entries.

What skills and training do you need?

College diploma or equivalent; Knowledge of insurance product benefits and limitations; One to two years of experience in a customer service-related position; Strong decision-making skills and attention to detail; Excellent verbal and written communication; Good organizational skill and ability to prioritize; Proficiency in the Microsoft suite products; Clear and effective communication in English or French (written and verbal); other languages such as Spanish are an asset; Available to work daytime schedule. Evenings and weekends may be requested with appropriate notice.

We offer you

Competitive wages; Bilingual language premium when applicable; Group health /dental benefits, RRSP matching; Paid training and the opportunity for professional development; Growth and advancement opportunities; Work life balance; Focus on health and wellness initiatives with an excellent EAP program; Employee engagement programs that focus on fitness, food and fun.

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