Job Opportunities in Canada

We are seeking a Claims Assessor (12 Month Term) to join our Coughlin team in Winnipeg, MB.
The Claims Assessor (12 Month Term) is primarily focused on claims adjudication and handling the daily volume of telephone inquiries into the Claims Department. The Claims Assessor processes group plan member health & dental claims by applying established policies and procedures, responds to inquiries (either by telephone, written, e-mail, web portal and/or walk-in) related to claims, benefits payable, and general group plan policies.

The Claims Assessor (12 Month Term) will:

• Process paperless and traditional claims, and using the claims system to properly identify missing information on forms.
• Verify eligibility of members, drugs, services, providers, co-insurance, deductibles, payments, and procedure/dental codes, including reviewing previous submissions and group contracts/policies.
• Verify letters, forms, and addresses for accuracy and completion.
• Interpret policies and administrative practices and correctly apply them in the adjudication of claims.
• Perform data entry related to claims and member correspondence.
• Convert specialist codes to comply with the fee guide.
• Investigate complaints, over and underpayments, and take corrective action.
• Respond to clients, members, or other external contacts in a prompt, efficient, and courteous manner at all times.
• Provide accurate and timely information/assistance to members and clients concerning coverage, processing, and paying claims, and benefits parameters.
• Prepare correspondence using company standard templates for members, carriers, or clients.
• Restrict access to confidential information pertaining to the company and its stakeholders.
• Perform other related administrative duties as assigned.

To be successful as a Claims Assessor (12 Month Term) with Coughlin & Associates, you will need:

• Minimum 1 year of work related experience in a customer service environment.
• Sound knowledge in the concept of group or individual benefits administration.
• A strong understanding and vocabulary of medical and dental terminology.
• The demonstrated ability to provide excellent customer service in a fast-paced environment.
• Sound knowledge of Microsoft Office and standard office administration procedures.
• The demonstrated ability to learn and master new software and technology.
• The ability to extract and interpret or simplify information from various technical sources.
• Excellent grammatical, spelling, and communication skills.
• Strong mathematical and organizational skills, the ability to prioritize and multi-task, and the ability to manage time effectively.
• The ability to use tact and discretion to maintain information in the strictest of confidence.

All-star candidates will have:

• Experience in the group benefits and/or insurance industry.
• Training in industry related courses provided by CEBS (Certified Employee Benefits Specialists), LOMA (Life Office Management Association), or the ICA (International Claims Association).
• Experience processing electronic claims.
• Bilingualism in both official languages.

What's in it for you:

• Learn by working alongside our experts
• Assistance for the completion of industry designations
• Competitive compensation

At People Corporation we are committed to helping businesses succeed. We are a national provider of benefits, retirement, wealth, wellness, and human resource solutions. Our experts and solutions serve over 20,000 clients representing nearly 3 million Canadians. We offer customized solutions designed to fit the unique needs of businesses and their employees, members and stakeholders.

About Coughlin & Associates Ltd.:
Across the country, thousands of Canadians rely on Coughlin & Associates Ltd. to design and administer their group medical, dental, disability, life insurance and pension benefits. Coughlin is a full-service benefits consultant and third party administrator. Our services include:

• Group benefits consulting and plan marketing
• Plan administration and correspondence
• Claims adjudication and payment

Established in 1958, Coughlin & Associates Ltd. provides services to some of Canada’s most respected companies, unions and public service organizations
Providing an inclusive, accessible environment, where all employees and clients feel valued, respected and supported is something we're committed to. We are dedicated to building a workforce that reflects the diversity of the communities in which we live, and to creating an environment where every employee has the opportunity to reach their potential. If you require an accommodation or an alternative format of any posting please reach out to careers@peoplecorporation.com