*Claims Assistant (Medical) – 100% Remote

Job Description

Claims Assistant (Medical) 100% Remote

On behalf of our client, a renowned insurance company specializing in the design of innovative life, disability, and health insurance solutions, we are seeking a qualified professional to join the individual insurance claims team.

The incumbent will provide quality customer service and manage the entire claims process in relation to insured parties, brokers, and providers, in close collaboration with teams of consultants and rehabilitation specialists.

What is in it for you :

• Annual salary between $46.000 and $52.000, depending on experience.
• Permanent, full-time position.
• 100% remote work, with a required office presence in Saint-Hyacinthe one day per month.
• Work schedule : 35-hour week.
• Union benefits : Possibility for overtime pay at one and a half times the rate, or to accumulate it once 35 hours are completed.
• Leave : 13 annual holidays, including 3 days at Christmas and 3 days at New Year.
• Group insurance (after 3 months) : medical expenses, dental care, vision care, travel and roadside insurance.
• Defined benefit pension plan : equivalent to government plans (available after one year of service or 700 hours worked).
• FTQ stock program : employer contribution up to $250 after 3 months of service.
• Long-term disability insurance : full coverage in case of prolonged absence (6 months).
• Vacation : 10 days upon hiring, with additional days according to the collective agreement.

Responsibilities :

The incumbent will be responsible for processing individual insurance claims and ensuring that the service provided to insured parties, brokers, and providers is exemplary.

They will determine the eligibility of each claim and proactively manage it. This role also involves ongoing collaboration with specialized consultants such as doctors, psychiatrists, physiotherapists, and pharmacists, as well as the rehabilitation team, for comprehensive management of claim files.

Specific tasks :

• Analyze the insurer's obligations through a thorough evaluation of the medical evidence and facts supporting each claim, in compliance with contractual provisions and current regulations.
• Ensure communication with all stakeholders to obtain necessary information for decision-making.
• Inform concerned parties of decisions and action plans related to claims.
• Proactively manage claims to prevent entrenchment in disability.
• Maintain service levels within the established deadlines of the service.
• Adhere to the priorities defined by the department.
• Support team colleagues in case of absence or leave.
• Perform all other related tasks within the claims department.

What you will need to succeed :

• University studies in a relevant field.
• 2+ years of experience in a related field.
• Proficiency in Word and Excel software.
• Knowledge in law or medicine (an asset).
• Experience in customer service.
• Bilingual in English and French to assist clients in both languages.
• Excellent verbal and written communication skills.
• Adaptability and empathy.
• Strong interpersonal skills.
• Client-oriented.
• Excellent analytical and synthesis skills.
• Computer skills.
• Good organizational skills and respect for deadlines.
• Effective time and priority management.
• Autonomy and rigor.

Why Recruit Action?

Recruit Action (agency permit : AP-2000003) provides recruitment services through quality support and a personalized approach to job seekers and businesses.

Only candidates who match hiring criteria will be contacted.