Claims Examiner at North American Air Trav
United States
CAD 50k - CAD 60k
<div><div><div><link href="https://static.workforcenow.adp.com/mas/mdf-components/24.6.15/styles/froala_editor.pkgd.min.css" rel="stylesheet" type="text/css"></div><p style='margin:0in;font-size:15px;font-family:"Aptos",sans-serif;background:white;' data-pasted="true"><span style='font-size: 30px; font-family: "Open Sans", sans-serif; color: rgb(40, 189, 179);'>What you'll do</span></p><p style="margin-left:0in;"><span style="font-size: 18px; font-family: arial, sans-serif;">You process claim files according to company policies and procedures. This involves reviewing claims, recommending payment or denial, or requesting additional information. You process approved payments and/or denials for travellers and providers and set up payment requests from other insurers. Specifically, you will:</span></p><ul style="list-style-type: disc;"><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">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.</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">If claim requires additional supporting documentation to confirm payability, request and review medical history, medical records, itemized bill, etc. following established SOPs. </li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Process payments and/or denials to travellers and/or providers.</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Set up requests for payment from provincial medical plans, extended health plans, and any other insurers.</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Assist Customer Service Team by providing claim information to help resolve travellers’ phone and email inquiries.</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Achieve performance targets.</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Collaborate and communicate effectively with team members and all other teams. </li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Responsively and effectively handle issues.</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Look for ways to improve customer experience.</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Promote and model TuGo culture, values, and brand promise.</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Continuously build professional and technical expertise.</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Other duties as required.</li></ul><p><br></p><p><span style='font-size: 30px; font-family: "Open Sans", sans-serif; color: rgb(40, 189, 179);'>What you'll bring</span></p><ul style="list-style-type: disc;"><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Degree or Diploma in a business-related discipline</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Successful completion of Level 2 Insurance Adjuster’s license or Level 1 General Insurance License is required within 12 months of start date</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Ability to learn and apply knowledge of policy wordings to accurately process claims </li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Strong analytical, problem solving and decision-making skills, detail-oriented and well organized</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Excellent communication/customer service skills, particularly by phone and email</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Excellent written and verbal communication skills</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Fluency in French preferred or an additional language such as Spanish, Mandarin or Cantonese is an asset </li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Previous experience assessing claims is an asset</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Experience in customer service is an asset</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Ability to multi-task</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Strong interpersonal, and conflict resolution skills</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Knowledge of medical terminology an asset</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Criminal record check is a requirement of the position as required by insurance councils for licensing</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Strong team player and positive contributor</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Proficient in MS Office Suite and able to learn applications quickly</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">Able to consistently live our values of valued, effective and trusted</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">A strong customer experience focus</li><li style="margin-left: 0in; font-size: 18px; font-family: arial, sans-serif;">A passion for continuous learning and professional achievement</li></ul><p><br></p><div><div class="fr-view"><div style='margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; color: rgb(0, 0, 0); font-family: "Segoe UI", "Segoe UI Web", Arial, Verdana, sans-serif; font-size: 12px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;'><div style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; overflow: visible; cursor: text; clear: both; position: relative; direction: ltr;"><div style='-webkit-user-drag: none; -webkit-tap-highlight-color: transparent; margin: 0px; padding: 0px; user-select: text; position: relative; color: rgb(0, 0, 0); font-family: "Times New Roman", "Times New Roman_MSFontService", serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;'><p><br></p><p><span data-ccp-props="{}" style="-webkit-user-drag: none; -webkit-tap-highlight-color: transparent; margin: 0px; padding: 0px; user-select: text; font-size: 11pt; line-height: 17.2667px; font-family: Arial, Arial_EmbeddedFont, Arial_MSFontService, sans-serif; color: rgb(0, 0, 0);"><span data-ccp-props="{}" style="margin: 0px; padding: 0px; user-select: text; -webkit-user-drag: none; -webkit-tap-highlight-color: transparent; font-size: 11pt; line-height: 17.2667px; font-family: Arial, Arial_EmbeddedFont, Arial_MSFontService, sans-serif; color: rgb(0, 0, 0);" id="isPasted"><em>Salary range: $50,000 - $60,000</em></span><br></span></p></div></div></div></div></div></div></div>
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