Talent.com
Claims Examiner

Claims Examiner

MSH Americas - Diot-Siaci GroupToronto, ON, Canada
2 days ago
Job type
  • Full-time
Job description

About Us : We are seeking ambitious individuals who share our values and our passion for making a positive impact on people's lives around the world. If you are looking for a career that challenges and inspires you, then you've come to the right place.About You : You are an experienced Claims Examiner who can handle a large case load, multi-task, and meet tight deadlines. You thrive in a fast-paced environment providing excellent customer service in both the claim turnaround and handling emails and incoming calls. You will have the desire to develop an in-depth understanding of this position and be able to easily maneuver through numerous policies to assess claims and inquiries accurately. You are a strong team player.You will be responsible for processing a variety of different claims and communicating these decisions to providers, members, and clients. You have strong time management skills, claims experience, and policy interpretation.In this role, you’ll get to experience : Process travel insurance claims for medical, trip cancellation / interruption, baggage, dental, and vision claims up to the designated limit.Adjudicate claims according to various benefit policiesHandle both inbound and outbound calls, and complaints, and provide excellent customer service for claims matters both in person and via written correspondenceWork closely with claimants, providers, agents, brokers, other insurance carriers, or their representativesWork closely with other departments within the company on a day-to-day basisMaintain accurate documentation on all claim filesAdjust reserves following the insurer’s guidelinesPresent cases and participate in discussions during file reviews and appealsEnsure all work complies with the PIPEDA and HIPAASupport department initiatives and objectivesProvide guidance and mentorship to peersOther related duties as assignedWhat you bring : High school diploma or University Degree or equivalentMinimum 2-3 years of relevant travel insurance or medical insurance claims processing experienceBilingual : English / French is requiredStrong analytical and problem-solving skillsHigh level of proficiency in Microsoft Office suitesSuperior verbal and written communication skills in English and / or FrenchStrong time management and organizational skillsMust successfully apply for Alberta Adjuster License within one month of hireWhat do you need to succeed?Snowbird, expatriate insurance, TPA experienceExperience in handling Canadian and US medical invoices / claimsDispute resolutions experienceGHIP recovery / coordination of benefits / subrogationSolid Team PlayerWhat’s in it for you : Hybrid work environmentExcellent health benefitsEmployee assistance programWellness accountRRSP matchingMinimum 3 weeks’ vacationGenerous allowances for sick and flex daysTuition reimbursement programOpportunities to learn new skills, grow, and move into different rolesA work environment that embraces diversity and promotes inclusivity.Supportive leadership prioritizes your success and cares about your well-being.A growth trajectory that is designed to expand both vertically and horizontally, providing you with opportunities to pursue your passions and acquire new skills.Additional NotesOur work week is Monday to Friday, 8 hours per day. The hours are flexible, with start times between 8 am and 10 am. Occasional flexibility in hours is required to meet the needs of the business.A laptop will be provided MSH is an Equal Opportunity EmployerMSH Americas is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other protected status under applicable law. We encourage and welcome applicants from all backgrounds to apply for our open positions.Removing obstacles to offer fair access to jobs is our top priority. When a candidate asks for reasonable accommodation throughout the application process, a Human Resources professional will assist them. The information provided during the accommodation request process will be handled, saved, and utilized in accordance with the laws that apply to it as well as the rules of MSH International.