Group, Claims Examiner III

First Canadian Financial Group; Edmonton; On-site; CAD 55,000 - 75,000; Full time

Benefits offered by this job

Vacation & PTO

Retirement plan with employer match

Health & Wellness Spending Account

Educational assistance

Early Friday finish

Employee Assistance Program

On-site gym

5% bilingualism premium

Job summary

First Canadian Group Benefits, based in Edmonton, is seeking a claims professional to adjudicate health and dental claims with accuracy. The role involves CRM-driven communication with plan members and clients, meeting production/quality standards, and contributing to process improvements.

Qualifications include 3-5 years in Canadian Group Benefits claims, fluency in English, and strong Microsoft Office skills.

Qualifications

• University or diploma or certificate preferred or equivalent experience.
• 3-5 years health and dental claims experience within the Canadian Group Benefits industry.
• Demonstrated ability to multi task and meet tight deadlines.
• Intermediate skills with Microsoft Office (Word/Excel).

Responsibilities

• Data entry to adjudicate health and dental claims with a high degree of accuracy.
• Effectively uses a Customer Relationship Management system to track and respond to inquiries from plan members and clients within service standards.
• Meet production and quality standards for the claims team on a consistent basis.
• Other duties as assigned.

Skills

Fluent in English

Verbal and written communication

Ability to multi-task

Deadline management

Education

University/Diploma/Certificate preferred

Tools

Microsoft Office

Job description

LeMarchand Mansion
Edmonton, AB T5K 0J8, CAN

• On-site
• GROUP BENEFITS
• Full-Time
• Requisition #: GROUP002395

Description

Bring What You Know. Help Build What's Next.

First Canadian Group Benefits is growing nationally, and we're investing in the people, technology and capabilities that will support our next stage of growth.

A division of an established Canadian financial services organization, we have the stability and resources behind us to build for the future while remaining small enough that talented people can have a meaningful influence on where we're going.

Our employees work directly with senior Group Benefits leaders, including our President and Vice President. Ideas move quickly, expertise is valued and you'll have the opportunity to see the impact of your work.

We're looking for people who want more than a narrowly defined role. People who can get into the details, solve problems and understand the operation while also stepping back, thinking strategically and asking how we can make it better.

If you've built your Group Benefits expertise and are ready to use it to help build what's next, this could be the opportunity you've been looking for.

What We Offer

• Vacation and Earned Time Off program
• Group Retirement Savings Plan with employer match
• Employee benefits plus Health & Wellness Spending Account
• Educational assistance and career development
• One-hour early finish on Fridays
• Employee Assistance Program and employee discount programs
• On-site gym
• 5% bilingualism premium for qualified professional-level French bilingualism, where applicable

Why This Opportunity is Different

You've built your expertise. Put it to work.

We're looking for more than someone who knows how to perform the role. We want someone who understands the business well enough to help us improve it.

Bring the knowledge you've developed throughout your career - the practices that work, the processes that don't and the ideas you've wanted to implement - and help us build an even stronger experience for our clients.

What You’ll Influence

• Claims adjudication practices, procedures and service standards.
• Process improvements that support quality, efficiency and member experience.
• Enhancements to claims workflows and technology based on frontline experience.
• Training, knowledge sharing and development of less-experienced team members.
• Emerging issues, trends and opportunities that should be considered as our Claims function evolves.

Growth creates opportunity

As our business has grown, employees have had opportunities to expand their responsibilities and move into leadership positions. We're continuing to build the capabilities and leadership structure our future business will require.

Where you'll work

Our Group Benefits team works together in-office in Edmonton. We believe the stage we're at as a growing business benefits from close collaboration, immediate access to leaders and the ability to solve problems together.

What you'll do

• Data entry to adjudicate health and dental claims in accordance with the terms and conditions of policy coverage with a highdegree of accuracy.
• Effectively uses a Customer Relationship Management system to track and respond to written and telephone inquiries from planmembers and clients within established service standards.
• Meet production and quality standards for the claims team on a consistent basis.
• Other duties as assigned.

Qualifications:

• University/Diploma/Certificate preferred or other academic/professional experience equivalencies may be considered.
• A minimum of 3-5 years health and dental claims experience within the Canadian Group Benefits industry.
• Demonstrated ability to multi task and meet tight deadlines.
• Intermediate skills with Microsoft Office (Word/Excel).
• Fluent in English with proven competencies in verbal and written communication is required.
• Fluent in French with proven competencies in verbal and written communication is an asset.
• Successful completion of a credit, criminal, education, employer reference/verification, and professional designation checksbefore employment is required.

Check out our company page for all the information on why we believe First Canadian is an employer of choice!

Thank you for considering our organization.

We are an equal opportunities employer and welcome applications from all suitably qualified persons. Accommodations are available upon request.