Temp to Full Time Claims Examiner 100% remote Toronto or Calgary Job Overview You are an experienced Claims Examiner who can handle a large case load, multi-task, and meet tight deadlines. You thrive in a fast-paced environment providing excellent customer service in both the turnaround of the claim and handling emails and incoming calls. You will have the desire to develop an in-depth understanding of this position and be able to easily maneuver through numerous policies to accurately assess claims and inquiries. You are a very solid team player. The Claims Examiner will be responsible for processing a variety of different claims and communicating these decisions to providers, members, and clients. This role requires strong time management skills, claims experience, and policy interpretation. Responsibilities - Process travel insurance claims for medical, trip cancellation/interruption, baggage, dental and vision claims up to the designated limit - Adjudicate claims according to various benefit policies - Handle both inbound and outbound calls, complaints,
provide excellent customer service for claims matters both in person and via written correspondence - Work closely with claimants, providers, agents, brokers, other insurance carriers or their representatives - Work closely with other departments within the company on a day-to-day basis - Maintain accurate documentation on all claim files - Adjust reserves in accordance with the insurer’s guidelines - Present cases and participate in discussions during file reviews and appeals - Ensure all work complies with the PIPEDA and HIPAA - Support department initiatives and objectives - Provide guidance and mentorship to peers - Other related duties as assigned Qualifications and Education Requirements - High school diploma or University Degree or equivalent - Minimum 2-3 years of relevant travel insurance or medical insurance claims processing experience - Bilingual: English/French is required - Strong analytical and problem-solving skills - High level of proficiency in Microsoft Office suites - Superior verbal and written communication skills in English and/or French - Strong time management and organizational skills