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27 Sep 2016

Full-Time Senior Claims – Bilingual Travel

Insurance Career Network – Posted by Jan Mahood –  Toronto, Ontario, Canada

Job Description

Bilingual Travel Claims Subject Matter Expert

Our client is seeking a bilingual experienced and seasoned Travel Claims professional, who is passionate about claims processing. You understand in-depth all the complexities of claims processing and policy administration. You have an investigative mind, strong adjudication and analytical skills.

The Role:

You will process health, trip cancellations and travel claims. You will be responsible for understanding all policies and act as the subject matter expert for claims processing procedures and policy administration.

Responsibilities:

·         Processes Health, Dental, Vision, Travel, Trip cancellation claims

·         Adjudicates claims according to various benefit policies

·         Handles both inbound and outbound calls to members and health providers as required

·         Provides excellent customer service for claims matters and escalations

·         Strong letter writing skills to providers, member and clients

·         Helps Claims team problem solve and uses sound judgment / discretion to proactively address and resolve problems

·         Supports Claims Team in understanding client policies, systems, workflows, issues and expectations

·         Work closely with Assistance team, Finance Team, Medical Director and other teams on day to day operations

·         Supports department initiatives that increases revenues, save costs and meet company objectives

·         Removes barriers to improve performance to enhance effectiveness and efficiency.

·         Act as a Subject Matter Expert for all claims related matters

·         Applies methods to proactively identify, monitor and intervene as required on potential high dollar/problematic claims or potentially fraudulent claims.

·         Identify claims trends and communicate to appropriate internal and external parties

·         Ensures all work in a PIPEDA and HIPAA compliant manner.

·         Other related duties as assigned

Qualifications:

·         Experience in the Travel Insurance industry is required

·         Minimum 5+ years of relevant Claims experience

·         Experience handing Legal cases.

·         High level of proficiency in Microsoft office suites

·         Superior verbal and written communication skills

·         Strong time management and organizational skills

·         Fluent in French

Assets:

·         Travel, Snowbird, Expatriate Insurance, TPA experience

·         Cost containment/provider relations experience

·         Experience with medical coding standards

·         Dispute resolutions experience

How to Apply

Insurance Career Network is a recruitment firm focused exclusively on the insurance industry.  Our long term relationships, knowledge and leading experience enable us to connect insurers, brokerage firm and independent adjusting firms with the most talented candidates for each role. Our recruiters come directly from insurance related positions and bring a wealth of knowledge to each recruitment assignment. We listen to your requirements as a job seeker. We ask a lot of questions to help us understand your experience and your comfort level for potential opportunities or career progression. We can identify the right companies and jobs for your talent. We maximize your time investment by arranging interviews that are suitable and a fit. How to Apply Send your resume directly to jan@insurancecareernet.com or call Jan 416 703-5120 ext. 202 for more details.

Job Categories: Manager. Job Types: Full-Time. Job Tags: French, medical, and travel.

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