Salary Range: CA$40,000.00 To CA$45,000.00 AnnuallyCompany OverviewEpic Health Solutions boasts over 35 years of experience in the healthcare industry, providing innovative solutions in an ever-evolving marketplace. As part of an award-winning enterprise group, we're proud to support a global team of more than 500 employees dedicated to enhancing healthcare services.SummaryWe are seeking a detail-oriented, bilingual Claims Examiner to join our Travel Insurance team at Epic Health Solutions. In this role, you will review, investigate, and adjudicate travel insurance claims while communicating professionally with insureds, brokers, and medical facilities in both English and Portuguese. This position is essential to maintaining claims accuracy and supporting our operational goals.Key ResponsibilitiesReview, investigate, and adjudicate Travel Insurance claims (Medical, Trip Cancellation/Interruption/Delay, Baggage Loss/Damage/Delay) in accordance with policy terms and conditionsCommunicate effectively and professionally in both English and Portuguese with insureds, agents/brokers, medical facilities, and other stakeholders to collect documentation and explain claim status and decisionsAnalyze medical records and other supporting evidence to determine coverage and validity of claimsRespond to claim inquiries and complaints from insureds and brokers in a timely, courteous mannerMaintain accurate reserves and ensure timely updates to the claims management systemDraft transparent, accurate, and compliant claim denial letters that cite applicable policy language, in both English and Portuguese as neededParticipate in quality reviews, training,



and continuous improvement initiativesPerform other duties as assignedQualifications2-3 years of experience in claims examining or adjusting insurance claims (Travel, Health, or related field)Bilingual fluency in English and Portuguese (spoken and written) required; must be able to professionally read, write, and speak with agents, medical facilities, and brokers in both languagesStrong understanding of travel insurance policies and benefits considered an assetExcellent analytical, problem-solving, and decision-making skillsStrong attention to detail and accuracyStrong written and verbal communication skillsAbility to prioritize tasks and manage deadlines in a fast-paced environmentProficiency with MS OfficeCore CompetenciesClaims Adjudication · Customer Service Excellence · Accuracy and Attention to Detail · Communication · Time Management · Accountability · Problem Solving · Teamwork · ProfessionalismJob TypeFull-timeExpected HoursSchedule8-hour shift, Day shift, Monday to FridayWork LocationHybridLanguage RequirementsEnglish and PortugueseDental careEmployee assistance programExtended health careLife insuranceOn-site parkingPaid time offRRSP matchAccessibilityEpic Health Solutions is committed to providing an inclusive and accessible work environment and complies with the Accessibility for Ontarians with Disabilities Act (AODA). We are dedicated to ensuring equal opportunities for all applicants. If you require accommodations during the recruitment process, please email us at [email protected] and we will work with you to meet your needs.

📌 Claims Examiner (Markham)
🏢 National Healthcare Solutions
📍 Markham