Bilingual Claims Examiner

Description:

Reporting to the Senior Manager, Claims, Bilingual Claims Examiner will be handling traditional insurance claims with the room to expand into other lines of business. You will spend your days reviewing, researching, verifying, approving, or denying claims.

What you will do

Respond to inquiries by mail or phone. You will place and accept calls involving customers, physicians, lawyers, and investigators. You will respond to questions regarding claims, eligibility verification, and payments. You will review supportive documentation, benefit forms, and certificates.
Analyze. You will accurately examine traditional insurance claim files within the processing guidelines according to the certificate provisions; updating information; and document the claim file with written notations of the claim status and related payment information.
Document. You will prepare the policy decision for additional review if applicable. You will create detailed claim documentation, writing letters, and completing associated forms.

What you bring

The communication skills. You have exceptional written and verbal skills. You can remain calm during times of stress, conflict, or emotionally heavy details. You are comfortable communicating by phone or email with customers, internal teams, lawyers, and other professionals. You are fully bilingual in French and English.
The experience. You have insurance claims experience. You have knowledge of insurance practices and principles as well as medical terminology. FLHC, FLMI, or ALHC designation is beneficial but not required.
The ownership. You hold yourself highly accountable for meeting your deliverables. You are analytical, detail-oriented, and have impeccable decision-making skills. You value the expertise of others and have the confidence to defend your choices. You can work autonomously in a fast-paced, deadline-oriented environment, balancing competing priorities. You are driven by the need to make the lives of others easier.