Benefits TPA Operations Lead
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Job Location:
Monthly Salary:
Posted on:
2 hours ago
Vacancies:
1 Vacancy
Job Summary
About EIO:
At EIO we help small businesses deliver better employee benefits and workplace experiencessupporting employee well-being while enabling employers to attract and retain top talent. Our approach is practical and data-driven grounded in what we call Employee Investment Optimization.
As part of our fully remote team youll enjoy flexibility competitive compensation and benefits and opportunities for professional growth within a collaborative and high-performing environment. Were proud of the culture weve built and are entering an exciting phase of growth. If youre thoughtful motivated and interested in contributing to
meaningful work EIO offers a place to build and grow your career. Join us and be part of whats next.
About the Position:
We are seeking a Bilingual Benefits Administration Manager to lead our TPA operations and member support this role you will establish internal SOPs manage claims adjudication workflows oversee daily helpdesk operations and act as the primary escalation point with insurance carriers and TELUS claims partners. This is a fully remote role with opportunities to shape processes lead a team and make a meaningful impact on member experiences.
In this role youll be:
Building and leading claims adjudication and member support teams
Managing day-to-day helpdesk operations using HubSpot Helpdesk
Establishing and continuously improving TPA SOPs and benefits administration
workflows
Acting as the primary escalation point with insurance carriers and third party partners
Who This Role Is Perfect For:
This role is ideal for someone who is ready to grow into a leadership role while staying close to the work. You may currently be a senior claims adjudicator or benefits administrator who enjoys supporting members and is excited about helping shape how a modern TPA operates.
Youll do well in this role if you:
Enjoy a hands-on role and take pride in delivering great member experiences
Are eager to develop your leadership skills by mentoring others and leading by
example
Like improving processes building SOPs and making things work better over time
Are comfortable being a trusted escalation point and working directly with carriers
and partners
Want flexibility autonomy and a role where your contributions truly matter
This is a great opportunity to build your career in a growing organization take on meaningful responsibility and help shape the future of benefits administration.
What Youll Be Doing
Document and maintain internal SOPs for claims processing and member support
Handle member support inquiries and escalations as we build the team
Build lead and manage a team of claims adjudicators and member support
specialists
As the team grows oversee daily helpdesk operations including ticket prioritization
and escalation resolution
Manage escalations with insurance carriers and TELUS claims adjudication partners
Ensure claims are adjudicated accurately timely and in accordance with plan
documents
Monitor team productivity quality metrics and service standards
Provide bilingual (French & English) support for complex member inquiries and
escalations
Support group setup plan configuration and onboarding activities as needed
Review and optimize workflows across TELUS Adjudicare and HubSpot Helpdesk
Collaborate cross-functionally to resolve operational issues and improve member
experience
Ensure compliance with privacy and regulatory requirements (PHIPA / PIPEDA)
Must Have Skills & Experience
Bilingual French/English required
47 years of experience in claims adjudication benefits administration or TPA/insurer
environments
At least 2-3 years in a supervisory role
Proven experience leading teams and managing claims and member support
workflows
Experience establishing SOPs and driving process improvements
Hands-on experience with TELUS Adjudicare (strong asset)
Knowledge of insured ASO and cost-plus plans including HSA / HCSA
Experience using HubSpot Helpdesk or similar ticketing systems
Experience managing claims appeals and escalations
Comfortable acting as the primary escalation point with carriers and claims partners
Strong understanding of Canadian extended health and dental plans
Excellent leadership communication and problem-solving skills
Ability to work independently in a fully remote environment
Why Youll Love Working with EIO
Fully remote role work from anywhere in Canada
Lead a collaborative tech-forward and member-focused team
Opportunity to shape internal processes and SOPs from the ground up
Meaningful work helping members access their benefits efficiently
Key Skills
- Sales Experience
- Microsoft Office
- Customer Service
- Communication skills
- Microsoft Outlook
- Microsoft Word
- Business Management
- Benefits Administration
- Microsoft Excel
- Insurance Sales
- Customer relationship management
- Human Resources
About Company
Give more to your employees-better benefits, working experiences, and even wages- by finding smarter ways to invest. EIO Advisors can show you how.
