Bilingual Claims Examiner

• Review the system, claim documents, and contracts to confirm if eligibility requirements are met
• Responsible for follow-up calls to plan sponsors and plan members within 24 hours of receiving initial claim information
• Communicate via telephone or email with plan sponsors or members to verify any inconsistencies or missing/inaccurate information
• Draft denial letters intended for plan sponsors and affected members
• Assess and manage claims with a predetermined limited duration (known as "Quick Pay" claims)
• Escalate files: If a claim does not meet "Quick Pay" eligibility criteria, transfer the file to the Disability Case Manager (DCM) for assessment and management, and to DCAs (Disability Claims Assistants) for benefit calculations
• File and organize documents accordingly

• Minimum of one year of experience in a customer service environment
• Excellent oral and written communication skills in both French and English (considered a strong asset)
• Ability to understand complex instructions and basic contractual language
• Basic knowledge of medical terminology
• Excellent typing and data entry skills
• proficiency in Microsoft Office programs
• Demonstrated excellence in telephone etiquette and customer service
• Strong organizational and time management skills, with the ability to manage multiple priorities effectively
• Experience working in the disability insurance field is considered an asset

Experience working in the disability insurance field

• Career advancement opportunities
• Potential for a permanent position