Group, Claims Examiner II
- Edmonton, AB, T5K 0J8, Canada
Full-time
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Job details
- Job type
- Full-time
- Experience
- A minimum of 3-5 years health and dental claims experience within the Canadian Group Benefits industry.
- Posting language
- English
- Posted
Original job description
Bring What You Know. Help Build What's Next.
First Canadian Group Benefits is growing nationally, and we're investing in the people, technology and capabilities that will support our next stage of growth.
A division of an established Canadian financial services organization, we have the stability and resources behind us to build for the future while remaining small enough that talented people can have a meaningful influence on where we're going.
Our employees work directly with senior Group Benefits leaders, including our President and Vice President. Ideas move quickly, expertise is valued and you'll have the opportunity to see the impact of your work.
We're looking for people who want more than a narrowly defined role. People who can get into the details, solve problems and understand the operation while also stepping back, thinking strategically and asking how we can make it better.
If you've built your Group Benefits expertise and are ready to use it to help build what's next, this could be the opportunity you've been looking for.
What We Offer
- Vacation and Earned Time Off program
- Group Retirement Savings Plan with employer match
- Employee benefits plus Health & Wellness Spending Account
- Educational assistance and career development
- One-hour early finish on Fridays
- Employee Assistance Program and employee discount programs
- On-site gym
- 5% bilingualism premium for qualified professional-level French bilingualism, where applicable
Why This Opportunity is Different
Learn more. See more. Grow faster.
In a larger organization, your role may expose you to one part of the Group Benefits lifecycle. At First Canadian, you'll have the opportunity to understand how the pieces connect, work closely with experienced leaders and contribute to a growing national business.
As the business grows, so can the scope of your experience.
Where You Can Make An Impact
- How claims processes and workflows evolve as we continue building our in-house claims capability.
- Opportunities to make the claims experience more efficient and effective for members and clients.
- Procedures and best practices that support accurate, consistent claims adjudication.
- Improvements identified through your day-to-day experience using our systems and processes.
- How knowledge and feedback from the Claims team are incorporated into future improvements.
Growth creates opportunity
As our business has grown, employees have had opportunities to expand their responsibilities and move into leadership positions. We're continuing to build the capabilities and leadership structure our future business will require.
Where you'll work
Our Group Benefits team works together in-office in Edmonton. We believe the stage we're at as a growing business benefits from close collaboration, immediate access to leaders and the ability to solve problems together.
What you'll do
Essential Responsibilities:
- Data entry to adjudicate health and dental claims in accordance with the terms and conditions of policy coverage with a high degree of accuracy.
- Effectively uses a Customer Relationship Management system to track and respond to written and telephone inquiries from plan members and clients within established service standards.
- Meet production and quality standards for the claims team on a consistent basis.
- Other duties as assigned.
Qualifications:
- University/Diploma/Certificate preferred or other academic/professional experience equivalencies may be considered.
- A minimum of 3-5 years health and dental claims experience within the Canadian Group Benefits industry.
- Demonstrated ability to multi task and meet tight deadlines.
- Intermediate skills with Microsoft Office (Word/Excel).
- Fluent in English with proven competencies in verbal and written communication is required.
- Fluent in French with proven competencies in verbal and written communication is an asset.
- Successful completion of a credit, criminal, education, employer reference/verification, and professional designation checks before employment is required.
Check out our company page for all the information on why we believe First Canadian is an employer of choice!
Thank you for considering our organization.
We are an equal opportunities employer and welcome applications from all suitably qualified persons. Accommodations are available upon request.
More about this job
Responsibilities
Accurately enter and adjudicate health and dental claims according to policy terms and conditions, while meeting established production and quality standards. Use the CRM system to track and respond to written and telephone inquiries from plan members and clients within service standards.
Requirements
Candidates should have 3–5 years of health and dental claims experience in the Canadian Group Benefits industry, along with strong communication, multitasking, and deadline-management abilities. A university degree, diploma, or certificate is preferred, as are intermediate Microsoft Word and Excel skills; French is an asset, and pre-employment background and verification checks are required.
Skills
- Health and Dental Claims Adjudication
- Claims Data Entry
- Policy Coverage Interpretation
- Member and Client Service
- Written Communication
- Verbal Communication
- Multitasking
- Deadline Management
- Microsoft Word
- Microsoft Excel
- Claims Quality Assurance
- Claims Production Management
- Process Improvement
- Attention to Detail
Benefits
- Vacation and Earned Time Off
- Group Retirement Savings Plan with Employer Match
- Employee Benefits
- Health and Wellness Spending Account
- Educational Assistance
- Career Development
- Early Finish on Fridays
- Employee Assistance Program
- Employee Discount Programs
- On-Site Gym
- Bilingualism Premium
Visa sponsorship
Not detected in the job text
Categories
- Customer Service & Support
- Finance & Accounting
- Administrative
Keywords
- Group Benefits
- Health Claims
- Dental Claims
- Claims Adjudication
- Canadian Group Benefits Industry
- Policy Coverage
- Claims Data Entry
- CRM
- Plan Members
- Client Inquiries
- Claims Production Standards
- Claims Quality Standards
- Microsoft Office
- Microsoft Word
- Microsoft Excel
- Written Communication
- Verbal Communication
- French
- Process Improvement
- Claims Workflows
- Service Standards
- Credit Check
- Criminal Check
- Education Verification
- Employer Reference Check