Bilingual Claims Administrator [Canada]

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As a Bilingual Claims Administrator, you will be responsible for being the main point of contact for the claimant and managing their claim from beginning to end. The Claims Administrator also works in support of the Adjudicator. The role requires flexibility with working hours between 8:00 a.m. and 8:00 p.m., Monday to Friday on a rotational basis. Flexibility for periodic weekend shifts and statutory holidays may also be required to support changing conditions, customer demand, and business needs.


Duties will include:

• Answer inbound claims status related calls from members, producers and others
• Proficiently determine the needs of the caller then provide accurate and timely resolution.
• Display high energy, passion and a positive attitude
• Meet tight timelines under pressure while delivering quality service
• Own the results, share work experiences and willingly seek and accept personal accountability
• Continuously learn about customers, their priorities and their expectations
• Take ownership and responsibility for resolving customer concerns with every interaction
• Be flexible, personally embrace change and commit to continuous learning
• Support the organization’s and the Claims Team’s key priorities
• Demonstrate leadership, model customer service values and drive quality and process optimization
• Manages business needs through entry level project and analysis work while assigning a high priority to customer excellence, quality and meeting service level agreements
• Manage the claim notification process: including updating various systems and maintaining the claims register, sending out claim requirements and regular ongoing follow up for outstanding requirements
• Communicate verbal and written information as appropriate to those with a need to know, ensuring information is clear, accurate and compliant with all legal, privacy, confidentiality and company standards
• Perform all required calculations and ensure all activities are in compliance with reinsurance treaties, legal and internal standards, including timely submission of information to the reinsurance companies and of the various tax information forms to government offices
• Assist other team members to ensure that the team meets objectives
• Create ad hoc correspondence and reports for members, producers and external partners
• Communicate with various Reinsurance Companies regarding the submission of claims under various reinsurance treaties, including the recovery of reinsurance funds owing on paid claims
• Receive, verify and match claims benefit cheques to be mailed to claimants
• Meet service level agreements and achieve productivity and quality standards
• Deal with customer complaints defined in company guidelines
• Meet privacy and compliance guidelines
• Additional responsibilities as required

Knowledge/Experience/Skills:

• Fluent in English and French
• Self-starter with demonstrated ability to prioritize own work and ability to research/problem solve and make decisions both independently and collaboratively within a fast-paced team environment
• Must be proficient in both verbal and written communication to effectively communicate with internal and external customers/partners and vendors
• Understanding of insurance products, services, systems and regulatory requirements, with the ability to recognize discrepancies, anomalies and inconsistencies
• Results-oriented with emphasis on accuracy and attention to detail and the ability to understand and balance both the short and long-term impact of decisions and actions
• Effective multi-tasking and time management skills, including the ability to adapt to changing demands and priorities
• Strong organization skills to effectively monitor and track information with quick ability to learn and leverage new technologies
• Strong reasoning and judgment to balance commitments, financial soundness and quality customer focus
• Creative problem-solving skills
• Mathematical skills needed for calculation of benefits, taxation and reinsurance
• LOMA 281 and 291 courses an asset
• Post-secondary education preferred and/or related work experience (minimum 1 year work experience)

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