Review, process, and analyze health insurance benefit claims for specialized products Analyze information contained in assigned files, taking into account contractual provisions, medical and/or death-related evidence, government programs, and internal policies and procedures Communicate decisions or recommendations primarily in writing regarding benefit approval, requests for additional information, or claim denials Provide customer service to insured individuals, policyholders, and/or beneficiaries Obtain specific information, communicate claim-related information, and respond to calls Perform technical tasks to support the management of assigned files Use relevant computer systems to update data and process payments in accordance with contracts and internal guidelines Requirements

Hold a college diploma (DEC) in a relevant field Advanced proficiency in French, both spoken and written Advanced proficiency in English, both spoken and written Core Competencies





Demonstrates expertise in analyzing health insurance benefit claims, ensuring compliance with contractual provisions and internal policies. Proficient in both French and English, facilitating effective communication with insured individuals and stakeholders. Highest-signal resume keywords

Health Insurance Claims Analysis Contractual Provisions Review Bilingual Communication Customer Service Data Processing ATS Optimization Keywords

Hard Skills

Claims Processing File Management Technical Analysis Data Updating Payment Processing Soft Skills

Written Communication Customer Interaction Certifications & Qualifications

College Diploma (DEC) Industry Keywords

Health Insurance Benefit Claims Government Programs Internal Policies Medical Evidence Tools & Technologies

Computer Systems

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📌 Health Insurance Claims Agent (Winnipeg)
🏢 Jobtailor
📍 Winnipeg