Group Benefits Claims Manager

First Canadian Financial Group•Edmonton, AB

2d•Onsite

About The Position

First Canadian is experiencing unprecedented growth and is seeking bright, hard-working individuals committed to learning, career growth, and opportunity. This organization prides itself on being a long-term employer that values employee opinions and feedback. The Manager, Group Health & Dental Claims is a hands-on leadership role crucial for the development of a newly formed group health and dental claims department. The ideal candidate will possess extensive experience in health and dental claims management and proven leadership skills to build a high-performing team. This role involves designing and optimizing claims processes, ensuring regulatory compliance, providing exceptional service, and exceeding performance metrics.

Requirements

This is a hands-on leadership role. The manager is expected to be directly involved in operational activities to ensure a thorough understanding of processes, responsibilities, and team functions.
Minimum 1-3 years experience of developing and leading a Health & Dental claims adjudication team.
Minimum 3-5 years experience in group benefits Health and Dental Claims adjudication with a deep knowledge of claims processing and regulations is required.
Excellent organizational, analytical and interpersonal skills with the ability to manage multiple priorities.
Strong problem-solving and decision-making abilities with a focus on providing a client focused approach.
Excellent communication skills with the ability to convey complex information clearly to various stakeholders.
Proficient in MS Office Suite (e.g. Word, Excel, Outlook, and PowerPoint).
Experience working with Customer Service Software (DialPad, HubSpot).
Fluent in English with proven competencies in verbal and written communication is required.
Successful completion of a credit, criminal, education, employer reference/verification, and professional designation checks before employment is required.

Nice To Haves

Bachelor’s degree in Human Resources, Business Administration or equivalent is an asset.
Fluent in French with proven competencies in verbal and written communication is an asset.

Responsibilities

Establish, mentor and lead a new claims processing team by fostering a collaborative environment that prioritizes accuracy, efficiency and employee engagement.
Design and implement health and dental claims processing workflows that ensure timely and compliant handling of claims.
Provide ongoing training and development opportunities for your team to ensure they are equipped with the necessary skills and knowledge.
Create a client service culture and embed client engagement by inspiring and motivating the claims team to provide the best claims experience in Canada.
Conduct regular health and dental claim file reviews and performance assessments, to identify and evaluate trends, to optimize processes and provide recommendations for technology enhancements.
Possess excellent communication strategies to handle disputes and escalations, working with claimants and Plan Sponsors to find fair resolutions.
Other duties as assigned.