Experience
Claim adjudicator
Claims Analyst
• Process client statements that include premiums, commissions, and claims into administration system (Omega journal) according to applicable client treaties.
• Support analytical review of administration upon received life insurance claims. Identify and research issues, draw conclusions, make recommendations, communicate and summarize issues of significance.
• Develop a cooperative relationship with insurance companies to ensure the life insurance claims are received in a timely manner.
• Work cooperatively and collaboratively with Claims, Actuarial and Finance teams to monitor and ensure claim is processed and paid accurately with established timelines.
Bilingual Customer Service Professional, Group Benefits
• • Establish a professional and yet candid interaction with the client to ensure a superior, better quality service experience and to be a problem solver with whatever issues they may have
• • Manage, resolve and recommend solutions to complex cases clients face daily, with precision and thoroughness
• • Collaborate strongly with a growing team and build work relationships (and teamwork) while providing excellent customer service
Vendor Management Coordinator – STD, LTD, Life, Disability & Group Benefits
Collaborate with STD, LTD & AMS case managers with their medical records and warn them of booked appointment
• Write many letters to EE (employees), ER (employer), and DR (doctor), and perform several clerical and administrative tasks (photocopying, fax, mail, phone) to send them
• Deal with important files regardless of the province (across Canada) or the insurance coverage (individual or group)
Medical intake coordinator
• • daily deal with disability insurance files
• • Process STD, LTD, AMS files for insurance companies, IMEs and even ergonomic assessments for government clients
• • Manage a large volume of healthcare assessments under time sensitive deadlines, in a fast-paced, collaborative team environment;
• • Resolve client inquiries and provide solutions in a timely manner;
• • Understand and execute our Service Level Agreements (SLA’s) to ensure our clients and healthcare professionals are receiving high level service;
• • Develop strong relationships with clients and healthcare professionals; and
• • Act as a key point of contact for claimants, clients and healthcare professionals
Education
Insurance medicine
Grad diploma/DESS