Claims Support Specialist Bilingual (ENG/FR)

Your newpany

Hays specialist recruitment is working with a Financial Services firm in Toronto. We are seeking a Claims support specialist to join their team immediately. This is a Bilingual role, fluency in both English and French is required. This is a full time role, Monday-Friday.

Your new role

Seeking Claims Support Specialist to support a high-profile claim processing initiative. This position blends technical expertise with emotional intelligence, requiring professionals who can manage sensitive inquiries, process documentation with precision, and engage empathetically with claimants who may face barriers due to trauma, mental health challenges, or poverty.

Call Centre:

• Respond to iing calls with empathy, professionalism, and discretion.
• Provide accurate information about the claims process while strictly adhering to confidentiality protocols.
• Escalate high-risk orplex cases to appropriate internal channels as needed.
• Maintain detailed and objective call notes in the system for documentation and audit purposes.

Support Tickets:

• Triage, assign, and resolve client or internal inquiries submitted via ticketing systems.
• Identify sensitive cases that may require escalation or prioritization.
• Ensure timely, respectful, andprehensive responses are logged and tracked.

Claims Coding and Claims Quality Checks:

• Code claim details based on policy documentation, accurately capturing sensitive or traumatic descriptions without alteration or bias.
• Conduct quality assurance checks to ensurepleteness, accuracy, andpliance with internal and regulatory standards.
• Identify inconsistencies or red flags and raise them for investigation or review.

What you'll need to succeed

• 1+ year of experiencemunicating with clients / patients / or stakeholders over the phone
• Must be bilingual English/French
• Experience in data entry
• Ability to speak an Indigenous language (i.e., Cree languages, Inuktitut, Ojibway etc.) is considered an asset
• Knowledge of Indigenous culture is an asset

What you'll get in return

This is a great opportunity for someone who wants to work within Claims. On the job training will be provided.