Job Description

Our client is looking to expand their claims team by on-boarding talented bilingual claims handler.  

What you will be doing:   

You will process claim files according to Company policies and procedures. This involves reviewing claims, recommending payment or denial, or requesting additional information. You will process approved payments and/or denials for travellers and providers and set up payment requests from other insurers. 

  • Process claims according to Company policies and procedures. This involves reviewing claims for completeness and compliance with policy coverage and recommending acceptance or denial of claim and expenses. 
  • If claim requires additional supporting documentation to confirm payability, request required information following established SOPs. 
  • Process payments and/or denials to travellers and/or providers. 
  • Set up requests for payment from provincial medical plans, extended health plans and any other insurers. 
  • Assist Customer Service Team by providing claim information to help resolve travellers’ phone and email inquiries. 
  • Provide backup telephone support for Medical Assistance Team for calls related to hospitalizations. 
  • Achieve performance targets. 
  • Collaborate and communicate effectively with team members and all other teams. 
  • Responsively and effectively handle issues. 
  • Look for ways to improve customer experience. 
  • Promote and model the company’s culture, values, and brand promise. 
  • Continuously build professional and technical expertise. 
  • Other duties as required. 

What we are looking for: 

  • Degree or Diploma in a business-related discipline 
  • Level 2 Insurance Adjuster’s license or Level 2 General Insurance License preferred 
  • Ability to learn and apply knowledge of policy wordings to accurately process claims 
  • Strong analytical and decision-making skills, detail-oriented and well organized 
  • Excellent communication/customer service skills, particularly using the phone 
  • Written and verbal fluency in English and an additional language – preferably French, Spanish, Mandarin, or Cantonese 
  • Previous experience assessing claims an asset 
  • Experience in customer service role an asset 
  • Ability to multi-task 
  • Strong interpersonal, and conflict resolution skills 
  • Knowledge of medical terminology an asset 
  • Criminal record check is a requirement of the position as required by insurance councils for licensing 
  • Once fully trained, work schedule will include some non-business hour shifts (weekend and evening shifts) 
  • Strong team player and positive contributor 
  • Proficient in MS Office Suite and able to learn applications quickly 
  • Able to consistently live our values of valued, effective and trusted 
  • A strong customer experience focus 
  • A passion for continuous learning and professional achievement 

 

DGA Careers has been proudly serving the Canadian insurance industry for over 30 years, specializing in providing insurance recruiting services to major insurers, insurance brokerage firms, and independent adjusting firms. With offices in Toronto, Vancouver, Montreal, Edmonton, and Calgary, DGA Careers is well-positioned to conduct searches with a national scope. Our unrivaled professional network across Canada provides us with the ability to reach vital key influencers and passive candidates nationally.  

Interested candidates, please email your resume in confidence to Bea Dizon at bea@dgacareers.com or at 778-383-9790 ext. 102. If you are working with another DGA Recruiter, feel free to ask them for more information about this position. 

Job Posting Details

Job Type

Full-Time
Permanent

Market Segment

Insurance
Property Casualty Insurance

Company Type

Recruiting Consultants

Education Required

Adjuster's License
Agents License
CIP
Insurance License
Insurance License Level 1
Insurance License Level II

Minimum Experience Required

1 to 2 Years

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