Bilingual Claims Administrator

Job Description

<p><b>Join a team where your passion meets purpose! We're not just colleagues – we're enthusiasts who genuinely love what we do and make work enjoyable for everyone.</b></p><p><br></p><p><b>About Our Claims Team:</b></p><p>Join our dynamic claims team as a Claims Administrator! We're looking for an organized, customer-focused professional who enjoys helping people and thrives in a collaborative environment. In this role, you'll be the friendly voice our members and healthcare providers rely on for support with their claims questions and concerns.</p><p><br></p><p><b>About you:</b></p><p>As a Claims Administrator, you'll handle a variety of tasks from answering phone calls and emails to processing claims and ensuring everything runs smoothly. You'll work closely with our claims processing team and have opportunities to develop expertise in insurance policies and procedures.</p><p><br></p><p><b>What You'll Do</b></p><ul><li><b>Customer Service Excellence</b> - Provide outstanding support to plan members and healthcare providers through phone, email, and written correspondence</li><li><b>Communication Hub</b> - Handle incoming and outgoing calls, respond to email inquiries, and ensure everyone gets accurate, timely information</li><li><b>Claims Support</b> - Assist claims processors with adjudication, enter new claims into our system (Magenta), and help resolve complex cases</li><li><b>Administrative Tasks</b> - Organize incoming mail, validate coverage, document all interactions, and maintain organized filing systems</li><li><b>Payment Processing</b> - Generate payments for approved claims and coordinate with Accounting; prepare denial notifications for members and providers</li><li><b>Compliance</b> - Ensure all work meets PIPEDA and HIPAA requirements</li><li><b>Special Projects</b> - Process Morcare claims for iA and handle pending claims reviews</li></ul><p><br></p><p><b>What We're Looking For</b> <b>Required:</b></p><ul><li>High school diploma or equivalent</li><li>2-3 years of administrative experience</li><li>Travel insurance industry experience</li><li>Strong skills in Microsoft Office (Word and Excel)</li><li>Excellent communication skills (both written and verbal)</li><li>Great organizational abilities and time management skills</li><li>Problem-solving mindset and attention to detail</li></ul><p><br></p><p><b>Preferred Qualifications:</b></p><ul><li>Experience with snowbird, expatriate insurance, or TPA services</li><li>Cost containment or provider relations background</li><li>Health, dental, or vision claims processing experience</li><li>Knowledge of medical coding standards</li><li>Experience with the coordination of benefits or subrogation</li><li>Familiarity with US medical invoices and claims</li></ul><p><br></p><p><b>What We Offer:</b></p><p>✓ <b>Flexible hybrid work setup</b></p><p>✓ <b>Comprehensive health benefits</b></p><p>✓ <b>Employee assistance program</b></p><p>✓ <b>Wellness spending account</b></p><p>✓ <b>RRSP matching</b></p><p>✓ <b>Minimum 3 weeks' vacation (plus generous sick and flex days)</b></p><p>✓ <b>Tuition reimbursement</b></p><p>✓ <b>Real opportunities for growth and skill development</b></p><p>✓ <b>Inclusive, diverse workplace culture</b></p><p>✓ <b>Leadership that genuinely cares about your success and well-being</b></p><p>✓ <b>Clear paths for both vertical and horizontal career growth</b></p><p><br></p><p><b>Don't check every box? Apply anyway!</b></p><p><br></p><p>We believe diverse backgrounds and perspectives make us stronger. We're an equal opportunity employer committed to creating an inclusive environment where everyone can thrive. Need accommodations during the application process? Our HR team is here to help.</p>