CLIENT SUCCESS SPECIALIST - CLAIM ADJUDICATION

When it comes to health, we’re always looking for ways to push for better. It’s why we were founded in the first place. In 1957, our founder, pharmacist William Wilkinson, witnessed a mother sacrifice her health by forgoing her own medicine to pay for her sick daughter’s prescription. He knew there had to be a better way. So, he introduced North America’s first prepaid drug plan, and GreenShield was born as a not-for-profit with a mission to support better health for all Canadians.

We aren’t just a health and benefits company. We’re the only not-for-profit social enterprise that brings worlds of coverage and care together, all in one place.

We’re noble challengers, purposefully building a better way and we need the best people to help us create a more holistic approach that takes care of the mind and body.

Our mission is to create better health for all Canadians, and we know that starts with our employees.

THE ROLE IN A NUTSHELL

• Support the GSA Team (Business Development, Account Management, Product) to secure service and retain client business, ensuring Service Levels are met or exceeded.
• Respond to varied client service requests in regards to their benefit plans, reporting needs and system access, as required.
• Represent GSA in departmental initiatives and organizational projects as required.
• Key business representative and liaison supporting client driven development requests, and managing requirements for various system enhancements, initiatives, and projects. This includes developing process documentation and conducting user acceptance testing as required, supporting Senior Client Success Specialists.
• Foster strong and effective client relationships, aligning with the Account Management Team.
• Host meetings and lead workshops, gathering requirements from key stakeholders, while identifying opportunities to improve business processes and enhance client satisfaction.
• Support Senior Client Success Specialists to manage communication with our IT team to determine a clear understanding of business requirements; ensuring adequate representation of requirements and test case scenarios applying user stories; support Agile Scrum and Kanban based methodologies.
• Responsible for understanding, adhering to, and evolving our processes within GSA, our Partners and the broader Enterprise.
• Support Senior Client Success Specialists to facilitate and appropriately capture requirements, implementation plans, and conversion plans including building testing and deployment activities as required.
• Maintain and evolve support documentation and reference materials for both internal and external use.
• Analyze system issues raised and see through to resolution, ensuring a proactive approach when reviewing; work closely with the technical support team to resolve production support issues.
• Work to identify both process and / or technology gaps and risks, including possible mitigation.
• Liaise with IT and other areas within the organization (e.g., Claims, Contact Centre Services) as a key GSA stakeholder to ensure our clients’ interests are represented in our evolving products and services.
• Work with complex data structures to perform extensive root cause analysis and issue resolution.
• Develop a deep understanding of the health benefits and claims processing landscape by collaborating the GSA team and clients.
• Some overnight travel will be required to destinations such as Montreal, Quebec City and / or Toronto.

WHO WE ARE LOOKING FOR

Data analysis using Oracle SQL and PL / SQL considered an asset.

GS supports diversity, equity and inclusion in our teams and communities, and we value the unique contributions made by all. Even if your experience doesn’t align perfectly to every requirement, we invite you to apply. We encourage applications from all candidates and will accommodate needs under human rights legislation throughout all stages of the recruitment and selection process. Please let us know of any accommodation through requestforaccommodation@greenshield.ca. Information received relating to accommodation will be addressed confidentially.

Providing this information gives GS consent to use your personal information to assess your suitability for specific positions, future opportunities or for your personnel file. Your résumé will be held in strict confidence and will be viewed only by the Organization. Information may be stored outside of Canada and could be used for aggregate statistical purposes (which uses no personal identification).

AI Usage - GreenShield leverages AI to help produce Job Descriptions, and ideate on interview questions. We also leverage AI for interview transcription support.

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