Group Benefits Claims Operations Manager

Lead group health and dental claims operations in Edmonton, using adjudication expertise to build stronger processes, teams, and service delivery.

First Canadian Group Benefits seeks a Manager to oversee health and dental claims adjudication. You will recruit and develop examiners, design workflows, support claims technology, and align operations with senior leadership. This opportunity suits an experienced group benefits professional ready to shape a growing function.

Key Responsibilities:

• Recruit, onboard, and develop a high-performing claims adjudication team
• Design compliant workflows from claim submission through payment or denial
• Support claims platform evaluation, development, and enhancement
• Audit claim files and use metrics to improve performance
• Resolve complex or disputed claims with claimants and Plan Sponsors

Requirements:

• 5-7+ years of group benefits claims adjudication experience
• 1-3+ years leading a claims adjudication team
• Knowledge of claims regulations and processing standards
• Bachelor's degree or equivalent education
• Microsoft Office proficiency and strong analytical communication skills

Bring claims leadership, workflow design, and analytical expertise to build First Canadian's health and dental operations.

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