Bilingual Claims Analyst

Bilingual Claims Analyst

Full-time Permanent

Location : Toronto - Hybrid

Hours : Mon-Fri –8 : 30am-5pm (40 hours / wk.)

Salary : Up to 75,000

Company : Our client is a licensed Life and Health Agency with Property and Casualty Broker licenses throughout Canada. Due to continued growth, they are looking to add a key member to their team of claims professionals.

Perks :

Company-paid health benefit plan (start day 1)

Healthcare spending account

Wellness spending account

Life Insurance

RRSP

Employee Development

Casual dress code policy

Job Overview

The incumbent will be responsible for reviewing, processing and reporting incoming Life and A&H claims. Using client, processing and business knowledge, he / she will conduct in-depth reviews and report unusual reporting trends / issues to stakeholders. This position will involve ongoing communication with internal departments and external clients.

Responsibilities :

• Review, validate and process claims on a day-to-day basis in alignment with Service Level Agreements for claims philosophy and practices.
• Conduct claim reviews through treaty validation and trending analysis to assess validity and accuracy.
• Develop a thorough understanding of each client and its mode of operations (ie reporting formats, frequencies, etc). Act as a subject matter expert for assigned clients as well as operations processes and controls.
• Liaise with clients to understand and / or correct reporting deviations and errors.
• Analyze and update control reports and escalate any issues with potential or known financial impact.
• Acts as liaison between internal stakeholders, senior management and clients to understand and report all claims volumes, issues, etc
• Actively seek enhancements and make recommendations for new processes to improve efficiencies or rectify inaccuracies or information gaps.
• Provide support to members of the Administration department.

Qualifications & Expertise