Claims Processing Specialist

WCG International Consultants Ltd.; Toronto; Remote; CAD 50,000 - 55,000; Full time

Benefits offered by this job

Competitive salary

Health and dental benefits

RRSP matching

Learning and development

Generous time-off

Diverse and inclusive workplace

Makes a difference

Job summary

WCG in Canada is seeking a Claims Processing Specialist to handle performance-based funding and related financial supports for clients and employers. You will work with the Claims Manager to ensure accuracy, compliance and confidentiality.

The role requires strong auditing, data entry, and MS Office skills, with 2-3 years in a service-focused role; bilingual English/French is preferred. We offer a competitive salary, health benefits, RRSP, learning opportunities, generous time off, and a diverse

Qualifications

• Strong auditing background and data entry experience.
• 2–3 years’ experience in a similar role in a service-oriented organization.
• Proficient in MS Office especially Excel and Word.
• Detail oriented with a high level of accuracy.
• Ability to adapt to change.
• Understanding of high confidentiality environments.
• Able to stay composed under pressure.
• Results driven with problem solving abilities.
• Excellent organizational and time management skills.
• Ability to work in a fast paced environment with changing workload.

Responsibilities

• Process client and employer financial support claims and ensure contractual and legislative requirements are met.
• Ensure quality assurance for claims/invoices processed by staff.
• Answer inquiries from staff regarding claims and other administrative questions.
• Communicate issues regarding ineligible claims per processes.
• Provide support and guidance to staff on claims processing as required.
• Stay updated on trends in claims assessment and flag for the manager.
• Be flexible to adjust activities to changing requirements.
• Escalate discrepancies and refer staff to appropriate partners as needed.
• Protect organizational interests and manage risks as appropriate.
• Develop understanding of WCG’s contract, guidelines, and processes.
• Undertake standard and ad hoc data entry tasks.
• Use WCG’s Case Management System and related databases effectively.

Skills

Auditing background

Data entry

MS Office (Excel, Word)

Attention to detail

Adaptability

Confidentiality

Time management

Organizational skills

Fast-paced work

Tools

MS Office Suite

Excel

Word

Job description

We believe in the power of work.Since 1994, we’ve been partnering with governments and local agencies across Canada to create sustainable employment opportunities for people, businesses and communities. We understand that work gives hope, strengthens relationships and drives economic growth.

Job Description

About the role

Location: Remote - Canadian Home Office

As a Claims Processing Specialist, you’ll be responsible processing performance-based funding alongside employment- related financial supports for clients and employer expenditures.You will work closely with the Claims Manager and Financial Quality and Support Specialist to ensure accuracy, compliance and continuous quality improvement while maintaining high level of confidentiality pertaining to client records and financial information.

What you'll do

• Process client and employer financial support claims and ensuring contractual and legislative requirements are met
• Ensure quality assurance for claims/invoices processed by Service Provider staff
• Answer inquiries from staff regarding claims and other administrative questions
• Communicate any issues regarding ineligible claims in line with processes
• Provide support and guidance to staff regarding claims processing in line with contractual and guideline requirements
• Keep abreast of emerging trends for claims assessment and flag these to the Claims Manager.
• Demonstrate flexibility to be able to change activities based on changing requirements and business needs '
• Ensure discrepancies are handled appropriately and escalating issues when necessary; refer staff to appropriate team members or internal partners as appropriate
• Protect the interests of the organization – identify and manage risks, and escalating issues when necessary; refer staff to appropriate team members or internal partners as appropriate
• Develop a strong understanding of WCG’s contract, guidelines, policies, and process
• Undertake standard and ad hoc data entry tasks
• Effective use of WCG’s Case Management System and other systems and databases

Qualifications

What you bring

• Strong auditing background and data entry experience
• Minimum 2-3 years’ experience in a similar role working in a service-oriented organization
• Proficient in MS Office especially Excel and Word
• Detail oriented with a high level of accuracy
• Ability to adapt to change
• Understanding of the needs of a highly confidential environment
• Able to maintain composure during difficult and high-pressure situations
• Results driven with creative approach to idea generation and problem solving
• Excellent organizational and time management skills
• Ability to working in fast paced environment with changing workload

Preferred Criteria:

• Bilingual (English and French)
• Knowledge of the Employment Services industry

Additional Information

What we offer

• Competitive salary of $53,040.00 per year
• Comprehensive and flexible health and dental benefits
• RRSP Matching program of 2.5% base earnings
• Ongoing learning and development opportunities
• Generous time-off policies that promote work/life balance
• A diverse and inclusive workplace with a track record of high employee engagement and teamwork
• The opportunity to do work that makes a difference!

Diversity, Equity, Inclusion and Belonging Matter

WCG isstrengthened by diversity. We arecommitted to achieving a workplace that is equitable and representative of Canada’s diverse population. We actively work to attract, develop, and retain employees from diverse and equity-deserving backgrounds who have exceptional ability and the desire to make a difference. We continuously strive to support individual needs and differences in a work environment that is built on inclusivity and respect for everyone.

WCG is committed to providing an accessible, barrier free recruitment and selection process. If contacted for an employment opportunity, please advise us if you require accommodation in advance of any part of the recruitment and selection process.