Bilingual Medical Claims Administrator – 100% Remote

Recrute Action

6d•$55,000 - $65,000•Remote

About The Position

Insurance role focused on claims analysis in both group and individual contexts, involving interactions with various stakeholders and medical professionals. This position offers a flexible remote work environment, benefits starting on day one, a stable schedule, and conditions that support work -life balance.

Requirements

College diploma or university degree in a relevant field.
2 years of experience in a similar role or a related field, including customer service.
Excellent communication skills with a strong client -focused approach.
Bilingual in English and French to support clients in both languages.
Strong analytical and problem -solving skills with attention to detail.
Strong interpersonal skills, empathy, and adaptability.
Ability to work independently with strong organizational and time management skills.
Proficiency in computer tools, including Word and Excel.

Nice To Haves

Knowledge of legal or medical concepts is considered an asset.

Responsibilities

Analyze group and individual insurance claims by evaluating medical evidence, contract provisions, government programs, and applicable legal aspects.
Determine eligibility of claims and ensure proactive case management to optimize outcomes.
Communicate with insured members, employers, brokers, providers, and healthcare professionals to gather relevant information for decision -making.
Clearly and effectively communicate decisions and action plans to all stakeholders.
Collaborate with medical consultants and rehabilitation teams in case follow -ups.
Ensure compliance with established processing timelines and service standards.
Participate in departmental activities and projects and support colleagues as needed.

Benefits

Salary between 55K -65K, depending on experience.
4 weeks of vacation from the start of employment.
35 -hour workweek, scheduled between 8:00 am and 5:00 pm.
Full -time remote work with a required presence at the Saint -Hyacinthe office once per month.
Group insurance from day one, including medical, dental, vision, travel, and roadside assistance coverage.
Defined benefit pension plan equivalent to government plans, available after one year of service.
Employee assistance program.
Paid sick days.
On -site fitness room.
Social activities organized throughout the year, including BBQs, Christmas parties, and Halloween events.
Various employee discounts, including the Saint -Hyacinthe privilege card and insurance products.
Ongoing training opportunities.
Recognition of years of service.