Claims Adjudication & Member Support Specialist

395 Client Experience; Winnipeg; On-site; CAD 45,000 - 55,000; Full time

Benefits offered by this job

Extended health care and dental

Retirement savings plan with company**

Health & Wellness offerings

Industry designations support

Competitive compensation

Job summary

People Corporation is seeking a Claims Adjudication Specialist to deliver excellent service to plan members and providers. You will adjudicate health and dental claims, verify data, and respond to inquiries by phone and email with a focus on accuracy and client satisfaction.

The role emphasizes confidentiality, teamwork, ongoing training, and participation in meetings. Base salary ranges from CAD 45,000 to CAD 55,000 with potential bonus components.

Qualifications

• 3+ years of relevant professional experience in a service related role (Insurance, Health & Dental benefits claims)
• Demonstrated expertise in customer service, with a strong focus on anticipating, meeting, and exceeding customer needs.
• Excellent analytical skills and strong attention to detail.
• Sound knowledge of Microsoft Office and standard office administration procedures.
• Consistent and clear communication, addressing concerns respectfully with excellent verbal and written abilities.

Responsibilities

• Adjudicate Health and Dental claims up to $1,500 on the adjudication platform.
• Ensure that service standards are met or exceeded.
• Interact with plan members and service providers via phone and email to provide responses to inquiries about claims, eligibility and services.
• Obtain, analyze, and verify the accuracy of claim submissions and data.
• Initiate and/or implement correct action as needed to ensure an excellent service standard and a high level of client satisfaction is maintained.
• Maintain security and confidentiality of client information.
• Actively participate in training on new product offerings and various process updates.
• Actively participates in huddles & team meetings, and share learnings in a constructive manner.

Skills

Customer service

Analytical skills

Verbal and written communication

Time management

Tools

Microsoft Office

Job description

People Corporation is seeking a Claims Adjudication Specialist to deliver excellent service to plan members and providers. You will adjudicate health and dental claims, verify data, and respond to inquiries by phone and email with a focus on accuracy and client satisfaction.

The role emphasizes confidentiality, teamwork, ongoing training, and participation in meetings. Base salary ranges from CAD 45,000 to CAD 55,000 with potential bonus components.