Adjustment Adjudicator
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Job Location:
Monthly Salary:
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
The Adjustment Adjudicator plays a critical role in ensuring the timely and accurate processing of Health & Dental claim adjustments while supporting complex escalations that directly impact customer outcomes. By resolving issues efficiently and improving the accuracy of claim decisions this role actively supports Manulifes purpose to Make Decisions Easier and Lives Better.
In this role you will develop deep expertise in claims systems and adjudication practices while collaborating closely with crossfunctional partners across the Canadian Division and global operations. This opportunity offers meaningful exposure to complex claim scenarios continuous learning and the ability to make a tangible impact on the customer experience.
Position Responsibilities:
Process Health & Dental adjustments including stop payments cheque reissues system updates exceptions and retroactive claim reviews.
Investigate claim issues from internal partners and resolve escalations with strong customer focus and urgency.
Prepare clear professional communications to plan members regarding claim outcomes or required information.
Reconcile suspense account items and support SOX audit compliance.
Complete manual history loads outofcountry history processing and unclaimed property investigations.
Support process improvements provide peer training and collaborate across business units to meet service expectations.
Required Qualifications:
Minimum 3 years administrative or business operations experience
Strong working knowledge of Microsoft Office 365
Superior understanding of claims payment systems and Health & Dental adjudication practices
Strong customer service focus with the ability to take initiative
Ability to work effectively both independently and within a team in a fastpaced environment
Strong interpersonal skills with the ability to collaborate at all levels across the Canadian Division and global teams
Preferred Qualifications:
Excellent verbal and written communication skills (English and French)
Sound knowledge of medical and dental terminology provincial legislation and regulatory requirements
Experience working across multiple business units or functional areas
Demonstrated ability to manage multiple priorities while maintaining accuracy
Strong analytical problemsolving and decisionmaking skills
Highly organized resilient and adaptable in changing environments
When you join our team:
Well empower you to learn and grow the career you want.
Well recognize and support you in a flexible environment where well-being and inclusion are more than just words.
As part of our global team well support you in shaping the future you want to see.
About Manulife and John Hancock
Manulife Financial Corporation is a leading international financial services provider helping people make their decisions easier and lives better. To learn more about us visit is an Equal Opportunity Employer
At Manulife/John Hancock we embrace our diversity. We strive to attract develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment retention advancement and compensation and we administer all of our practices and programs without discrimination on the basis of race ancestry place of origin colour ethnic origin citizenship religion or religious beliefs creed sex (including pregnancy and pregnancy-related conditions) sexual orientation genetic characteristics veteran status gender identity gender expression age marital status family status disability or any other ground protected by applicable law.
It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process contact .
Referenced Salary Location
Canada Full Time RemoteWorking Arrangement
Salary range is expected to be between
$38175.00 CAD - $63625.00 CADIf you are applying for this role outside of the primary location please contact for the salary range for your location. The actual salary will vary depending on local market conditions geography and relevant job-related factors such as knowledge skills qualifications experience and education/training. Employees also have the opportunity to participate in incentive programs and earn incentive compensation tied to business and individual performance.
Manulife offers eligible employees a wide array of customizable benefits including health dental mental health vision short- and long-term disability life and AD&D insurance coverage adoption/surrogacy and wellness benefits and employee/family assistance plans. We also offer eligible employees various retirement savings plans (including pension and a global share ownership plan with employer matching contributions) and financial education and counseling resources. Our generous paid time off program in Canada includes holidays vacation personal and sick days and we offer the full range of statutory leaves of absence. If you are applying for this role in the U.S. please contact for more information about U.S.-specific paid time off provisions.
Key Skills
- Clerical
- English Language
- Administration
- Compliance
- Investigative reports
- SSA
- AS400
- Critical thinking
- CMS
- Computer Operating
- Mathematics
- Medicine
- Customer and Personal Service
- Personnel Security
- Safety and Security
About Company
Manulife is a leading financial services group. We provide financial advice, insurance, as well as wealth and asset management solutions for individuals, groups and institutions.
