Apply group benefits 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 perks position.

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