Claims Adjudicator - 3535

Are you looking for a challenging role where you will have the opportunity to have a huge impact on an industry leader?

Do you have outstanding relationships and a creative streak?

The Claims Adjudicator is accountable for handling claims in accordance with high service standards to meet or surpass client expectations.

Start date September 17, 2024

Advantages

• Fully remote role
• Earn competitive pay rate
• Possibility of conversion / Extension

Responsibilities

• Assesses highly complex health / dental claims in keeping with contract provisions, taking initiative and ensuring that empowered decision making is a key component of the process.
• Assume ownership of the claims assigned with an understanding of the urgency of specific cases and effectively prioritize work accordingly.
• Establish and maintain quality customer service within our turnaround times using influence with internal and external clients to meet all pre-established service standards in order to delight our customers..
• Commitment to Financial Efficiency and Continuous Improvement targets, as required
• Commitment to improving NPS (customer) scores based on overall goals

Supporting the Business :

• Sound knowledge and ability to apply appropriate risk management tools and techniques.
• Actively participate in various projects that improve effectiveness and efficiency in claims practices in keeping with our culture of continuous improvement.
• Manage all issues and requirements related to the claim to achieve customer / claim resolution handing off only as appropriate.

claims adjustments, warranty investigation, technical decisions)

Qualifications

Candidate Requirements / Must Have Skills :

1) Exceptional Communication Skills : Proficient in both verbal and written communication for diverse internal and external audiences.

2) Proficiency in Microsoft Office 365 : Strong working knowledge of the Office 365 suite of programs.

3) Detail-Oriented with Quick Assessment Skills : This role requires a keen eye for detail, as it involves reviewing receipts, extracting data, and accurately inputting information into the system.

An analytical mindset is essential to understand and make decisions based on the information presented.

4) Team and Individual Effectiveness : Proven ability to work effectively both independently and as part of a team in a fast-paced environment.

Soft Skills

• Strong customer service focus
• Ability to take initiative
• Excellent interpersonal skills and the ability to interact and work with others at all levels to achieve customer resolution

Nice-To-Have Skills :

• Bilingual English / French is an asset
• Previous claims adjudication and / or relevant insurance or health care industry experience a definite asset
• Previous call center and / or data processing experience an asset

Summary

If you are interested in this role, please apply in our website www.randstad.ca

Randstad Canada is committed to fostering a workforce reflective of all peoples of Canada. As a result, we are committed to developing and implementing strategies to increase the equity, diversity and inclusion within the workplace by examining our internal policies, practices, and systems throughout the entire lifecycle of our workforce, including its recruitment, retention and advancement for all employees.

In addition to our deep commitment to respecting human rights, we are dedicated to positive actions to affect change to ensure everyone has full participation in the workforce free from any barriers, systemic or otherwise, especially equity-seeking groups who are usually underrepresented in Canada's workforce, including those who identify as women or non-binary / gender non-conforming;

Indigenous or Aboriginal Peoples; persons with disabilities (visible or invisible) and; members of visible minorities, racialized groups and the LGBTQ2+ community.

Randstad Canada is committed to creating and maintaining an inclusive and accessible workplace for all its candidates and employees by supporting their accessibility and accommodation needs throughout the employment lifecycle.

We ask that all job applications please identify any accommodation requirements by sending an email to accessibility@randstad.

ca to ensure their ability to fully participate in the interview process.