As a Claims Adjudication Representative on our Customer Experience team, you’ll review Health Spending Account (HSA) and Wellness Spending Account (WSA) claims and make reimbursement decisions based on each member’s plan details and adjudication guidelines. Your decisions need to be accurate, consistent, and fair, and your communication with members needs to be clear, helpful, and respectful. If you like detail-oriented work that directly affects how people use their benefits, this role is for you.
What You’ll Do
Review HSA and WSA claims, checking receipts and supporting documentation to confirm each claim is valid and eligible
Apply eligibility criteria and plan rules to make consistent, well-reasoned, and unbiased reimbursement decisions
Make sure every decision complies with internal policies, external regulations, and industry standards
Communicate clearly with members about claim outcomes and any additional information needed
Work with Support and other departments to resolve member inquiries smoothly
Flag emerging patterns, unclear guidelines, or repeated issues to the Adjudication Coordinators and Head of Experience so they can be reviewed and acted on
Take part in team discussions and process improvement work
Keep up with changes to guidelines, regulations, and plan rules through ongoing training
Handle private and sensitive information with care, following our security and privacy standards
What You Bring
Strong analytical and critical thinking skills
Excellent attention to detail and accuracy
Clear written and verbal communication, with a professional, solution-oriented tone
Comfort with technology and learning new programs
Positive time management and reliable follow-throughA collaborative approach to working across teams
A genuine commitment to great customer service
Nice to have: Experience in claims, benefits, or insurance. It’s an asset but not required, we’ll train you!
Role Details
Salary: $48,000 - $50,000/year
Location: Hybrid, with in-office days at our Calgary office (candidates must be in Calgary)
Schedule: Full-time, Monday to Friday
What You’ll Gain
You’ll be part of a growing benefits platform and play a direct role in shaping experiences used by businesses across Canada, with real room to learn and grow.
We support you with a comprehensive benefits package, including health, dental, vision, and spending accounts. Our vacation policy grows with you, starting at two and a half weeks and reaching four weeks of PTO after three years. You’ll have regular one‑on‑one check‑ins, clear performance management, and open feedback, so you always know where you stand and how to grow.
Our 17th Ave office is bright, recently redecorated, and stocked with good coffee, a drink fridge, snacks, and friendly people who make coming to work enjoyable.
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📌 Claims Adjudication Representative (Alberta)
🏢 myHSA
📍 Alberta