Job Description

Temporary Full Time

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We are looking for a Claims Review Specialist.

Reporting to the Supervisor, Claims Review the Claims Review Specialist is a key member of the Audit and Claim Verification team responsible for completing claim audit processes for a key Canada Life client. The main function of a Claims Review Specialist is to conduct standard claims reviews of providers and members. The Claims Review Specialist will also handle escalations and non-responses from other units within Canada Life.

What you will do 

• Conduct claims reviews, including assessment of documentation for preselected claims
• Handle referrals from other business units, to investigate concerns identified and follow up on non-responses
• Prepare communications to be sent to members and providers seeking confirmation or clarification of claim information
• Receive, file and action claim review documentation from providers and members
• Identify fraud risk factors of claims reviewed and escalate or refer for further investigation if appropriate

What you will bring 

• Post-secondary degree/diploma or equivalent work experience
• Education or work experience in an audit/quality/fraud discipline considered an asset
• Experience within a paramedical or other clinic setting considered an asset
• Excellent communication skills, both written and oral
• Ability to manage multiple demands with tight deadlines is necessary
• Strong technical skills
• Ability to work independently and collaboratively at all levels
• Understanding of Health Claims processes and business knowledge would be an asset
• Reliability Status Security Clearance – this can only be completed with candidates who receive an offer of employment. This is a personal security status that is required as a condition of employment before an employee can gain access to Protected B information, assets or work sites as outlined by the Government of Canada website. The cost of submitting these checks will be covered by Canada Life

This position will be located in the Winnipeg head office.

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The base salary for this position is between $47,600 - $64,400 annually. This represents base salary only and does not represent other variable compensation components of our total compensation ( i.e. annual bonus, commission etc). If you are selected to move forward in our recruitment process, your recruiter will be able to discuss additional details of our total rewards program with you.

Career opportunities will be open a minimum of 5 business days from the date of posting, closing dates will vary depending on the search activity. All applications received will be reviewed on a rolling basis.

Grow with Canada Life

We’re united by a shared purpose: to improve the financial, physical and mental well-being of Canadians. Our company is trusted by 1 in 3 Canadians and contributes to the strength of communities across the country.

We’re looking for people who live our values everyday: we step up, we do the right thing, and we deliver – for our customers, communities and each other. Are you someone who always strives to do the right thing, who steps up for themselves and others, and who delivers with impact? Then we want to hear from you!

What we offer

We’re committed to supporting our employees through every stage of their career. Here’s what you can expect as a full-time or part-time permanent team member:

• Career Development Opportunities for career advancement, access to industry-leading learning programs and up to $2,000 annually towards education reimbursement.

• Health & Wellness: Flexible health and dental benefits, plus a $5,000 mental health benefit to support your well-being.

• Time Off: In addition to regular vacation and personal days, we support community involvement with a volunteer day. 

• Financial Security: Company-matching pension plan, share ownership program and additional investment options.

• Rewards and Recognition: Employee recognition programs, service milestone celebrations, employee discounts and more!
• Emphasis on Community We provide a workplace where employees feel connected and supported through Employee Resource Groups (ERGs), mentorship programs, social clubs and events.

Learn more about Canada Life

We’re committed to removing barriers and ensuring equal access to employment. Applicants requiring reasonable accommodation during the application process may contact talentacquisitioncanada@canadalife.com All information provided will be handled in accordance with applicable laws and Canada Life policies.

Canada Life would like to thank all applicants, however only those who qualify for an interview will be contacted

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