Claims Processing Specialist

WCG International Consultants Ltd.; Toronto; Remote; CAD 48,000 - 60,000; Full time

Benefits offered by this job

Competitive salary

Health & dental benefits

RRSP matching 2.5%

Learning and development

Generous time-off

Diversity and inclusion

Meaningful work

Job summary

WCG International Consultants Ltd. is seeking a Claims Processing Specialist to handle performance-based funding and related supports. The role supports accuracy, compliance, and quality improvement while protecting client confidentiality.

You will work with the Claims Manager and Financial Quality Specialist to ensure contractual and regulatory alignment, provide guidance, and stay ahead of emerging claims trends. This remote Canadian home-office position emphasizes accuracy and teamwork.

Qualifications

• Auditing background and data entry experience.
• 2–3 years in a similar service-oriented role.
• Proficient in MS Office, especially Excel and Word.
• Detail oriented with high accuracy.
• Adaptable to change.
• Ability to maintain confidentiality.

Responsibilities

• Process client and employer claims meeting contractual and legislative requirements.
• QA claims/invoices processed by service staff.
• Answer staff inquiries on claims and administration.
• Escalate ineligible claims per processes.
• Guide staff on claims processing per contracts and guidelines.
• Monitor trends in claims assessment and alert the Manager.
• Adapt activities to changing requirements and business needs.
• Resolve discrepancies and refer to appropriate teams.
• Protect organizational interests by identifying risks.
• Learn WCG contracts, guidelines, policies and processes.
• Perform standard and ad hoc data entry tasks.
• Use WCG Case Management System and other databases effectively.

Tools

Excel

Word

MS Office

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 elevate non-standard, high-risk transactions / activities as necessary
• 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

For complete job requirements, see the full Job Description here.

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 is strengthened by diversity. We are committed 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.