French Bilingual- Claims Examiner

MP-WS3186071766- Anne Marie's replacement

Hiring Manager Name:  Arlie Britton

Hiring Manager Location:  Winnipeg, MB

Role Title: Intake Coordinator (Claims Examiner)

Work Style: In office training full-time 1-2 months until training is complete – Then Hybrid – 2 days per week

Location city(s): Winnipeg only

Number of Openings: 1

Anticipated Start Date: 3-4 weeks from offer

Duration:  March 30, 2027

Part-time or Full-time: FT

Reason for role: (staff aug/replace vacancy): Staff augmentation

Convert to Permanent:  Yes, there is potential for conversion

Pay rate range/limitations: $23.19/hr

Protected B Clearance Required?  Yes

Any specific tools/skillset:  Customer Service, Analytical Skills, Strong Communication

Job Summary

The Claims examiner will follow-up with both Plan Sponsors and Plan Members to obtain duly completed documentation, ensure the forms are fully completed and respond to any questions they may have on the claims process. They will also ensure the claim is accurately set-up on the system in accordance with the contract and any required group specific special features. 

Responsibilities:

• Review system, claim documents and contract to confirm if eligibility requirements are met.
• Accountable for the outreach call to Plan Sponsors and Plan Members within 24 hours of receipt of initial claim information.
• Responsible to communicate via phone calls/emails to verify any discrepancies, missing or unclear information from either Plan Sponsor or Plan Member.
• Responsible for declination letter to Plan Sponsor and Plan Member accordingly.
• Adjudicate and manage the claim if expected to be for a limited duration (known as Quick Pay claims).
• If claim does not meet eligibility for a Quick Pay claim, transfer the claim to the Disability Case Manager for claim adjudication and management and to DCAs for benefit calculation.
• File documents accordingly. 

Qualifications:

• Minimum of one year within a customer service environment.

• Excellent oral and written communication skills in both French and English would be considered an asset.
• Must be able to understand complex instructions and basic contractual language.
• Knowledge of basic medical terminology.
• Strong typing and data entry skills; proficiency with Microsoft Office programs.
• Demonstrates excellence in phone etiquette and client service.
• Strong and effective organizational and time management skills with the ability to manage multiple priorities.
• Working experience within disability insurance is an asset.