Manager, Group Health & Dental Claims

First Canadian Financial Group; Edmonton; On-site; CAD 80,000 - 110,000; Full time

Job summary

A national organization is looking for a Manager of Group Health & Dental Claims to lead a new claims department. This role involves developing a high-performing team, optimizing claims processes, ensuring compliance, and delivering exceptional service to members. Ideal candidates will have significant experience and proven leadership skills. Join us for an exciting challenge!

Benefits

Off work 1 hour early on Fridays

Group Retirement Savings Plan with employer match

On-site gym

Educational assistance

Health and Wellness spending account

Qualifications

• 1-3 years experience leading a Health and Dental claims adjudication team.
• 5-7 years experience in Health and Dental Claims adjudication.
• Fluency in English required; French is an asset.

Responsibilities

• Lead and mentor a new claims processing team.
• Design and implement health and dental claims processing workflows.
• Conduct regular claims file reviews to identify optimization opportunities.

Skills

Organizational Skills

Analytical Skills

Interpersonal Skills

Problem-Solving

Decision-Making

Communication Skills

Education

Bachelor’s degree in Human Resources or Business Administration

Tools

MS Office Suite

Customer Service Software

Job description

Job Details

Description

First Canadian is a national organization and we are experiencing unprecedented growth!

We aim to hire bright, hard-working people who share our values. We seek employees who are committed to learning, career growth, and opportunity. We take pride in being an organization that our employees support long-term. We believe in our employees and celebrate their success by asking for employee opinions and feedback so that we continue to be a Great Place to Work.

We Award Our Team With The Following

• Off work 1 hour early on Fridays.
• Earned Time-Off Program and vacation.
• Group Retirement Savings Plan with employer match.
• On-site gym.
• Educational assistance and career development.
• Employee benefits.
• Health and Wellness spending account.
• Employee Assistance Program (EAP).
• Employee discount programs.
• A Culture Team dedicated to diversity, inclusion, and employee programs.
• Employee recognition and appreciation events.
• Relocation Assistance
  
  

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

If you are motivated to succeed by helping people, then this is the opportunity for you!

Are you a seasoned professional in the Group Health and Dental claims field, looking to take on an exciting new challenge? Do you thrive on creating and leading teams while shaping processes in an innovative environment? If so, we have the perfect opportunity for you.

We are thrilled to announce a newly created position: Manager Group Health & Dental Claims. This leadership role is crucial in developing and managing our newly formed group benefits health and dental claims department. The ideal candidate will bring a wealth of experience in health and dental claims management, combined with proven leadership skills to build a high-performing team. As the Manager Group Health & Dental Claims, you will play a key role in designing and optimizing claims processes, ensuring regulatory compliance, while providing exceptional service to members and other stakeholders, all while exceeding performance metrics.

Essential Responsibilities

• Assist in the evaluation for a new Health and Dental Claims Adjudication software partner.
• Provide input to influence and shape continued development on our new Administration System.
• Establish, mentor and lead a new claims processing team by fostering a collaborative environment that prioritizes accuracy, efficiency and employee engagement.
• Design and implement health and dental claims processing workflows that ensure timely and compliant handling of claims.
• Provide ongoing training and development opportunities for your team to ensure they are equipped with the necessary skills and knowledge.
• Create a client service culture and embed client engagement by inspiring and motivating the claims team to provide the best claims experience in Canada.
• Conduct regular health and dental claim file reviews and performance assessments, to identify and evaluate trends to optimize processes and provide. recommendations for technology enhancements.
• Possess excellent communication strategies to handle disputes and escalations, working with claimants and Plan Sponsors to find fair resolutions.
• Other duties as assigned.
  
  

Qualifications

• Minimum 1-3 years experience of developing and leading a Health & Dental claims adjudication team is required.
• Minimum 5-7 years experience in group benefits Health and Dental Claims adjudication with a deep knowledge of claims processing and regulations is required.
• Bachelor’s degree in Human Resources, Business Administration or equivalent is an asset.
• Excellent organizational, analytical and interpersonal skills with the ability to manage multiple priorities.
• Strong problem-solving and decision-making abilities with a focus on providing a client focused approach.
• Excellent communication skills with the ability to convey complex information clearly to various stakeholders.
• Proficient in MS Office Suite (e.g. Word, Excel, Outlook, and PowerPoint).
• Experience working with Customer Service Software.
• An insurance designation is considered an asset (LOMA, CEBS (GBA), ICA, etc.).
• 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 checks before employment is required.
  
  

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.