In-Office Group Benefits Adjudicator | Claims & Compliance

Applytojobs; Kelowna; On-site; CAD 65,000 - 85,000; Full time

Benefits offered by this job

Group Benefits Plan

Growth Opportunities

In Office

Competitive Salary

Job summary

Applytojobs, a Kelowna-based benefits tech company, is seeking a Group Benefits Adjudicator with a minimum of 3 years’ experience in group benefits claims adjudication. You will adjudicate claims, guide clients through the member portal, and support the service team with accurate processing and timely decisions.

In this in-office role in Kelowna, BC, you’ll build strong client relationships, interpret plan designs and apply claim guidelines with precision.

Qualifications

• Minimum 3 years in an insurance company claims adjudication role.
• Exceptional interpersonal skills to build positive client relationships.
• Attention to detail and maintaining accurate client files.
• Ability to interpret and apply claim guidelines in ambiguous situations.
• Dedicated team player with initiative and accuracy.
• Strong organizational skills and ability to prioritize and multitask.

Responsibilities

• The adjudication of claims: collect and review relevant information to determine legitimacy, eligibility and benefit amount payable.
• Work with development team and product owners to develop processes for adjudication of claims.
• Process all claims accurately in a timely manner within service standards.
• Take ownership and resolve client issues, including interaction with customers in a client service capacity.
• Refer questionable claims for evaluation and provide recommendations to minimize fraud.
• Maintain and update all applicable system records.
• Ad hoc duties as required.

Skills

Interpersonal skills

Attention to detail

Organizational skills

Multi-tasking

Independent worker

Team player

Tools

MS Word

Excel

Outlook

Job description

Applytojobs, a Kelowna-based benefits tech company, is seeking a Group Benefits Adjudicator with a minimum of 3 years’ experience in group benefits claims adjudication. You will adjudicate claims, guide clients through the member portal, and support the service team with accurate processing and timely decisions.

In this in-office role in Kelowna, BC, you’ll build strong client relationships, interpret plan designs and apply claim guidelines with precision.