Bilingual (Fr/En) Claims Review Specialist

The Canada Life Assurance Company • Montreal, QC

1d • CA$47,600 - CA$64,400 • Hybrid

About The Position

We are looking for a Bilingual (French & English) Claims Review Specialist. Reporting to the Supervisor, Claims Review, the Claims Review Specialist is a key member of the Audit and Claim Verification team responsible for completing claim audit processes for a key Canada Life client. The main function of a Claims Review Specialist is to conduct standard claims reviews of providers and members. The Claims Review Specialist will also handle escalations and non-responses from other units within Canada Life.

Requirements

• Bilingualism (fluent in French and English) required, as the position will regularly serve our clients with English and French-speaking need
• Post-secondary degree/diploma or equivalent work experience
• Excellent communication skills, both written and oral
• Ability to manage multiple demands with tight deadlines is necessary
• Strong technical skills
• Ability to work independently and collaboratively at all levels
• Reliability Status Security Clearance – this can only be completed with candidates who receive an offer of employment. This is a personal security status that is required as a condition of employment before an employee can gain access to Protected B information, assets or work sites as outlined by the Government of Canada website. The cost of submitting these checks will be covered by Canada Life

Nice To Haves

• Education or work experience in an audit/quality/fraud discipline considered an asset
• Experience within a paramedical or other clinic setting considered an asset
• Understanding of Health Claims processes and business knowledge would be an asset

Responsibilities

• Conduct claims reviews, including assessment of documentation for preselected claims
• Handle referrals from other business units, to investigate concerns identified and follow up on non-responses
• Prepare communications to be sent to members and providers seeking confirmation or clarification of claim information
• Receive, file and action claim review documentation from providers and members
• Identify fraud risk factors of claims reviewed and escalate or refer for further investigation if appropriate

Benefits

• Career Development: Opportunities for career advancement, access to industry-leading learning programs and up to $2,000 annually towards education reimbursement.
• Health & Wellness: Flexible health and dental benefits, plus a $5,000 mental health benefit to support your well-being.
• Time Off: In addition to regular vacation and personal days, we support community involvement with a volunteer day.
• Financial Security: Company-matching pension plan, share ownership program and additional investment options.
• Rewards and Recognition: Employee recognition programs, service milestone celebrations, employee discounts and more!
• Emphasis on Community: We provide a workplace where employees feel connected and supported through Employee Resource Groups (ERGs), mentorship programs, social clubs and events.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree