Claims Care Analyst

What you will do

• Assess claims for benefit entitlement by reviewing all relevant contractual medical functional and occupational documentation in accordance with established routines and certificate provisions;
• Efficiently manage an active caseload ensuring compliance with client service standards best practice guidelines KPIs and turnaround times (TATs);
• Conduct thorough documentation of claim analysis and maintain accurate records as per company policies and procedures;
• Communicate professionally and empathetically both in writing and verbally with stakeholders to provide updates clarify claim status and explain decisions;
• Perform detailed phone interviews with clients or involved parties to gather information and discuss claim outcomes;
• Identify required supporting documents for current and future benefit payments and follow up diligently to obtain necessary information;
• Collaborate with team members plan sponsors and other stakeholders to uphold service standards and contribute to a positive and dynamic work environment;
• Participate actively in departmental projects and continuous improvement initiatives by identifying process optimization opportunities and adapting to changes;
• Perform other related duties as assigned.

What you will bring

• Post-secondary education or equivalent work experience; a College diploma (DEC) in a relevant field is preferred;
• Professional designations such as FLHC FLMI or ALHC are considered assets;
• Minimum of 1 year experience in insurance claims processing particularly in life disability and critical illness insurance;
• Medical knowledge obtained through claims assessment underwriting or experience in a medical or paramedical profession is an asset;
• Strong analytical and problem-solving skills with meticulous attention to detail and a commitment to high-quality service;
• Strong proficiency in English for communication with customers and colleagues;
• Strong proficiency in French for communication with customers and/or colleagues in Quebec;
• Ability to conduct sensitive phone interviews and convey decisions tactfully;
• Proficiency in Microsoft Office suite (Word Outlook) and case management software;
• Ability to multitask and prioritize effectively while meeting diverse deadlines;
• Professionalism under pressure with the ability to manage stressful situations and deliver difficult news empathetically;
• Positive attitude strong team spirit and adaptability to organizational changes.

Why join

• Flexible work arrangements with monthly financial allocations to support your work-life balance;
• Generous starting paid vacation time plus additional vacation days for every year of service;
• Paid volunteer day so you can dedicate time to a cause you are passionate about;
• Paid personal and wellness days to support your total wellbeing;
• Educational assistance of up to $3500 a year (with approval from your manager);
• Flexible health and wellness account (in addition to comprehensive drug and dental coverage) to help pay for a wide range of wellbeing services that are meaningful to you;
• Up to 14% of combined contributions to the RRSP matching program;
• Family-friendly maternity/parental leave and
• Many more benefits perks and programs.