Apply group perks claims expertise in Kelowna as an Adjudicator processing claims accurately while interpreting plan guidelines and eligibility requirements.
This full-time, permanent position requires at least three years in an insurance company claims adjudication role. You will support a technology-first Third Party Administrator and Payor serving employers, insurers, and members. The work includes client assistance, portal guidance, and collaboration with development teams and product owners.
Key Responsibilities: Review information to determine claim legitimacy, eligibility, and payable amounts
Process claims accurately within established service standards
Interpret plan designs and guide clients through the member portal




Resolve client concerns and support Customer Service interactions
Refer contentious claims and recommend actions minimizing fraud
Requirements: Minimum three years in an insurance claims adjudication role
Ability to interpret guidelines through ambiguous situations
Exceptional interpersonal skills for positive client relationships
Accurate, organized approach to complex mathematical calculations
Working knowledge of Microsoft Word, Excel, and Outlook
Bring claims adjudication, client communication, and plan interpretation skills to this Kelowna group benefits position.

#J-18808-Ljbffr

📌 Group Benefits Claims Adjudicator (British Columbia)
🏢 Simply-Benefits-2
📍 British Columbia