Claims Processing Specialist

WCG International Consultants Ltd.; United States; Remote; USD 32,000 - 43,000; Full time

Benefits offered by this job

Health benefits

RRSP matching

Learning opportunities

Generous time-off

Diverse workplace

Job summary

WCG International Consultants Ltd. is seeking a remote Claims Processing Specialist for the Canadian Home Office. You will process performance-based funding claims and related financial supports, collaborating with the Claims Manager and Quality Specialists to ensure accuracy and confidentiality.

The role requires auditing background, 2–3 years in a service-oriented setting, and strong MS Office skills. Remote work from Canada, with focus on compliance and continuous quality improvement.

Qualifications

• Proven auditing background and accurate data entry skills.
• 2-3 years in a service-oriented role.
• Proficiency with MS Office, especially Excel and Word.
• Ability to maintain high confidentiality and adapt to changing requirements.
• Strong organizational and time management capabilities.

Responsibilities

• Process client and employer financial support claims and ensure contractual and legislative compliance.
• Perform quality assurance on claims/invoices processed by staff.
• Answer inquiries regarding claims and administrative questions.
• Flag ineligible claims and communicate issues per processes.
• Provide guidance on claims processing in line with guidelines.
• Monitor emerging trends in claims assessment and escalate risks.
• Maintain strong understanding of contracts, policies and processes.
• Enter data and use case management systems effectively.

Skills

Auditing

Data entry

Attention to detail

Confidentiality

Time management

Adaptability

Organizational skills

Bilingual (English & French)

Tools

MS Excel

MS Word

Case Management System

Job description

Company 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 Descriptionhere.

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 isstrengthened by diversity. We arecommitted 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.

Passion and Lived Experience Matter!

If you don’t quite have the above credentials but feel passionate about this role and your ability to do it successfully, please APPLY ANYWAY! Tell us in your application why you believe you would be a great fit. We believe in developing talent and have a wide range of opportunities to support passionate team members as they grow towards their employment goals.