Bilingual Life & Critical Illness Claims Specialist – Moncton, New Brunswick, CA, E1C 8L3

Job Information

Job Description

Employment Type: Full Time, Permanent
Location: Moncton
Salary: Comprehensive Compensation
Reports To: Team Leader, Case Management Services

Medavie Blue Cross currently has a permanent full-time position available for a Bilingual Life & Critical Illness Claims Specialist within the Case Management Services team. In this position, you will be working and collaborating with a team of talented professionals in a fast-paced work environment to ensure service level standards are met. This position requires a bilingual candidate in both French and English to work on Atlantic, Ontario and Quebec accounts.

This role is focused on the adjudication of Life, AD&D & Critical Illness claims and will require communication and collaboration with other team members as well as group administrators to ensure all information is obtained in a timely fashion leading to appropriate claim decisions.

Key Responsibilities:

  • Life, AD&D and Critical Illness claims adjudication: reviewing coverage eligibility, assessing contractual definitions through medical information, identifying beneficiaries, telephone contacts, sending letters and paying the claims.
  • Communicate with doctors when required to obtain information that is relevant to the claim.
  • Prioritize and maintain workload to meet turnaround standards and ensure a positive customer experience.
  • Accurately document case management plan, decision, and payment of claim.
  • Apply provincial legislations to various claims scenarios.
  • Effective and consistent use of an electronic case management software.
  • Build effective relationships with colleagues and stakeholders such as group administrators and claimants.
  • Render decision on a timely basis and effectively communicate these decisions, at times potentially difficult decisions and manage escalations with employers and claimants.

Required Qualifications:

  • Education:  A post-secondary education.

           OR

  • Work Experience: Experience in insurance claims; experience directly with Life, AD&D, Critical Illness or Disability considered an additional asset.
  • Other Qualifications:
    • Strong written and verbal communication skills to successfully partner with different stakeholders including the claimant, their treatment providers and physicians, the employer, group administrators, human resources, and lawyers
    • Excellent customer service and telephone skills and the ability to communicate complex and difficult information clearly with tact and sensitivity.
    • A general understanding of the health care and insurance fields and health related terminology.
    • Motivation to learn, ability to multitask, excellent organizational skills.
    • An understanding of contract wording and the ability to thoroughly review medical reports and other types of documents
  • Computer Skills: Strong computer skills in the Microsoft Suite of products and ability to learn a claims management software. Experience working with an electronic case management software is an asset.
  • Language Skills: Strong verbal and written communication skills in both official languages with the ability to communicate clearly and concisely.

We are an Equal Opportunity Employer.

 

Medavie Blue Cross strives to foster a culture where everyone is enabled to achieve their full potential — a culture of diversity, equity and inclusion (DEI) where we live our values every day in the way we treat each other, our members and the communities we serve.

Accessibility is a top priority. For applicants with disabilities, we provide accommodations throughout the recruitment, selection and/or assessment process. If selected to participate in the recruitment, selection and/or assessment process, please inform Medavie Blue Cross Human Resources staff of the nature of any accommodation(s) that you may require in respect of any materials or processes used to ensure your equal participation. All personal information is collected under the authority of the Municipal Freedom of Information and Protection of Privacy Act.

We have implemented a COVID-19 Vaccination Policy as part of our ongoing efforts to protect the health and safety of our employees, partners, plan members and the communities where we live and work. For employees who must work in our offices, we have taken every precaution to ensure health and safety by providing strict protocols and practices to meet legislated client and company needs, as well as modifications to the worksites.

Proof of full vaccination is required for all employees at Medavie Blue Cross.

We would like to thank all candidates for expressing interest. Please note only those selected for interviews will be contacted.


Job Segment: Medical, Claims, Equity, Healthcare, Insurance, Finance

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