Operations Claims Examiner - Contract

Allianz Partners Canada; Cambridge; On-site; CAD 45,000 - 55,000; Full time

Job summary

A leading insurance firm is seeking an Operations Claims Examiner for a 6-month contract in Cambridge. The candidate will review and adjudicate insurance claims, communicate effectively with clients, and collaborate with internal departments. Ideal applicants will have post-secondary education, attention to detail, and are preferred to be bilingual in French and English.

Benefits

Personal and professional development programs

Work Well programs for work-life balance

International mobility opportunities

Qualifications

• 6–12 months of experience in a claims processing or administrative role.
• Ability to manage multiple tasks simultaneously.
• Familiarity with AI tools like ChatGPT.

Responsibilities

• Review and process a variety of incoming claims.
• Analyze claims to make adjudication decisions.
• Accurately document claim activity in databases.
• Place outbound calls to gather missing information.
• Respond to inbound calls regarding claim inquiries.
• Collaborate with departments to resolve escalated concerns.

Skills

Attention to detail

Decision-making skills

Communication skills

Customer service skills

Bilingual (French and English)

Education

Post-secondary education

Job description

Operations Claims Examiner - Contract

We’re seeking a detail-oriented and motivated Operations Claims Examiner to join our team on a 6-month contract. In this role, you'll be responsible for reviewing, evaluating, and adjudicating a variety of insurance claims in accordance with company policies and service standards. The ideal candidate is someone who thrives in a fast-paced environment, communicates effectively, and strives to resolve claims at the first point of contact whenever possible.

What you will do :

• Review and process a variety of incoming claims to ensure accurate payment in line with policy terms and within agreed service timelines.
• Analyze claims using internal systems and policy documents to make well-informed adjudication decisions.
• Accurately document claim activity and decisions in company databases.
• Initiate and process stop payment requests and reissue payments as necessary.
• Place outbound calls to clients or service providers to gather missing information required to adjudicate claims.
• Respond to inbound calls and emails regarding claim inquiries, escalations, and general questions.
• Draft and send professional correspondence to clients, providers, or internal teams.
• Collaborate with cross-functional departments to resolve escalated concerns, ensuring issues are addressed promptly and professionally.
• Maintain claim reserves in accordance with internal guidelines.
• Familiarity with AI tools like ChatGPT and similar technologies can help enhance productivity and support innovative problem-solving in daily tasks.

What you will bring :

• Post-secondary education, with 6–12 months of experience in a similar claims processing or administrative role.
• Strong attention to detail and the ability to manage multiple tasks simultaneously.
• Solid judgment and confident decision‑making skills.
• Excellent communication and customer service skills.
• Bilingual in French and English is highly preferred.

What we offer

• Our employees play an integral part in our success as a business. We appreciate that each of our employees is unique and has unique needs, ambitions and we enjoy being a part of their journey.
• We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of courses and targeted development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is key priority for us. This is why we build Work Well programs to provide you with peace of mind and give the flexibility in planning and arranging for a better work‑life balance.
• At Allianz we use some AI‑assisted technology as part of our recruitment process to help match candidates to roles based on skills, experience, job title, and location. AI supports our recruiters by enhancing the efficiency and accuracy of candidate assessments and job recommendations, while all applications are reviewed by our recruitment team and final hiring decisions are made by humans.

We therefore welcome applications regardless of race, ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations.

Great to have you on board. Let’s care for tomorrow.