French Bilingual- Claims Examiner

Role Title: Claims Examiner- Bilingual
Location: Winnipeg, MB 
Work Style: In-office, full-time during training; hybrid thereafter (2 days per week in office)
Employment Type: Full-time, contract
Contract Duration: 1 year from start date
Anticipated Start Date: Approximately 2 weeks from offer
Conversion Opportunity: Yes, potential for permanent conversion
Compensation: $19.92/hour

Job Summary

The Claims Examiner is responsible for reviewing, adjudicating, and managing disability claims in accordance with plan provisions and contractual guidelines. This role involves timely outreach to plan sponsors and members, verification of claim information, and accurate documentation, while delivering a high level of client service.

Responsibilities

• Review system information, claim documentation, and contracts to confirm eligibility requirements are met.

• Conduct outreach calls to Plan Sponsors and Plan Members within 24 hours of receiving initial claim information.

• Communicate via phone and email to clarify discrepancies and obtain missing or unclear information from Plan Sponsors or Plan Members.

• Prepare and issue declination letters to Plan Sponsors and Plan Members as required.

• Adjudicate and manage claims expected to be of limited duration (Quick Pay claims).

• Transfer claims that do not meet Quick Pay eligibility to the Disability Case Manager for adjudication and management, and to DCAs for benefit calculations.

• File and maintain claim documentation accurately and in a timely manner.

Qualifications

• Minimum of one year of experience in a customer service environment.

• Strong oral and written communication skills; bilingual proficiency in English and French is considered an asset.

• Ability to understand complex instructions and basic contractual language.

• Knowledge of basic medical terminology.

• Strong typing and data entry skills; proficiency with Microsoft Office applications.

• Demonstrates excellent phone etiquette and a high standard of client service.

• Strong organizational and time management skills with the ability to manage multiple priorities.

• Previous experience in disability insurance is considered an asset.