Claims Adjudication Representative (Remote)

People Corporation; Calgary; Remote; CAD 45,000 - 50,000; Full time

Job summary

A leading company in health benefits is seeking a Claims Adjudication Representative in Calgary. This fully remote role offers comprehensive training and the opportunity to develop skills in claims adjudication. Responsibilities include assessing claims, ensuring compliance, and providing excellent customer service. The position offers competitive compensation and health benefits.

Benefits

Extended health care and dental benefits

Retirement savings plan with company contributions

Health & Wellness offerings

Mental Health programs and support

Competitive compensation

Qualifications

• No prior industry experience required; training provided.
• Strong analytical and critical thinking abilities.
• Effective written and verbal communication skills.

Responsibilities

• Review and evaluate HSA and WSA claims based on established guidelines.
• Examine supporting documentation to verify claims.
• Communicate clearly and professionally with claimants.

Skills

Analytical Thinking

Attention to Detail

Communication

Job description

myHSA is a division of People Corporation and has been helping deliver benefits to Canadian employees since 2013. Starting as a cloud-based HSA solution in a paper-based industry, myHSA envisions simple, personal, and employee-focused health benefits. We are currently seeking a Claims Adjudication Representative to join our team in Calgary.

No prior industry experience is required—just a strong willingness to learn and grow! This fully remote role offers the chance to develop valuable skills in health and wellness claims adjudication, with comprehensive training provided.
As an Adjudicator, you'll assess Health Spending Account (HSA) and Wellness Spending Account (WSA) claims to determine eligibility under specific guidelines. Your role will involve evaluating receipts, reviewing claim details, and applying criteria to make informed reimbursement decisions.

The Claims Adjudication Representative will be responsible for:

• Claims Assessment: Review and evaluate HSA and WSA claims based on established guidelines.
• Evidence Analysis: Examine supporting documentation to verify the validity and relevance of claims.
• Decision Making: Apply eligibility criteria and guidelines to make fair and accurate reimbursement decisions.
• Compliance: Ensure compliance with internal policies, external regulations, and industry standards.
• Customer Service: Communicate clearly and professionally with claimants regarding claim outcomes and any additional information needed.
• Continuous Learning: Engage in ongoing training to stay current with changes in guidelines, regulations, and best practices.
• Social Awareness and Fairness: Ensure unbiased and equitable decisions for all claimants.

To be successful as a Claims Adjudication Representative with myHSA, you will need:

• No prior industry experience required—we will train you!
• Strong analytical and critical thinking abilities.
• Excellent attention to detail and accuracy.
• Proficient in using technology (we will train you on our claims management software).
• Effective written and verbal communication skills.
• Ability to work independently and manage time effectively in a remote work environment.
• A commitment to delivering excellent customer service.

What's in it for you:

• Learn by working alongside our experts.
• Extended health care and dental benefits.
• A retirement savings plan with company contributions.
• A suite of Health & Wellness offerings.
• Mental Health programs and support for you and your family.
• Competitive compensation.

At People Corporation, we are committed to helping businesses succeed. We are a national provider of benefits, retirement, wealth, wellness, and human resource solutions. Our experts and solutions serve over 20,000 clients representing nearly 3 million Canadians. We offer customized solutions designed to fit the unique needs of businesses and their employees, members, and stakeholders.

Salary Range: The annual base salary for this position ranges from $45,000 - $50,000. This only includes the base salary and does not account for other variable compensation components of our total package (wellness accounts, etc.).

Providing an inclusive, accessible environment where all employees and clients feel valued, respected, and supported is something we're committed to. We are dedicated to building a workforce that reflects the diversity of the communities in which we live, and to creating an environment where every employee has the opportunity to reach their potential. If you require an accommodation or an alternative format of any posting, please reach out to [e-mail].