Claims Analyst

Adecco is presently seeking candidates for an exceptional opportunity as a full-time Claims Analyst in Ottawa, ON, at a highly reputable and internationally recognized healthcare organization. In this position, you will play a crucial role in the oversight and preparation of appeals, which will undergo thorough review by the esteemed Appeals Committee of the Board of Directors. To be considered for this esteemed role, proficiency in both French and English is imperative, along with a University Degree or College diploma and a minimum of three years of relevant professional experience. Embrace this remarkable opportunity to contribute to an influential organization and take your career to new heights!

• Location: Ottawa, ON

• Shifts: Monday to Friday | Hybrid | 9:00AM – 5:00PM

• Job type: Full-time | Permanent

Duties and Responsibilities:

• Open appeal files by assigning a case number, preparing the files, and entering key information in the database

• Review, research, investigate and analyze formal appeal cases

• Communicate with appropriate parties to obtain additional information – this includes representatives of the Plan Administrator, compensation advisors, and the pension office

• Prepare and draft analytical summaries of each case

• Participate in Appeals Committee meetings by presenting the case summaries and providing plan design information

• Review administrative cases and authorize resolution where required

• Prepare correspondence in response to appeals, including the preparation and mailing of acknowledgment letters, status update letters, decision letters, and follow-up letters

• Assist in the preparation of reports

• Participate in the research of complex cases or issues.

Requirements and Qualifications:

• Post-secondary education (University degree or College diploma)

• Minimum of 3 years of experience in a related field. A suitable combination of education and experience will be considered.

• Fluent bilingualism (French and English)

• Excellent writing skills in French and English are essential.

• The candidate must have the ability to write, edit, revise, and present content in both official languages.

• Proven ability to communicate professionally and effectively with both internal and external stakeholders.

• Experience in operating word processing and presentation software (i.e. Microsoft Office Suite, Sharepoint).

• Must be organized and thrive in a fast-paced environment with multiple priorities.

• Ability to analyze and synthesize data from various and multiple sources.

• Ability to work effectively under pressure, as part of a team and individually.

• Effective presentation skills.

• Knowledge of the health insurance industry is an asset.

• Must be legally eligible to work, and reside in Canada

Don’t miss out on this Claims Analyst job in Ottawa, ON. Apply now! Our dynamic team of recruiters will reach out if you qualify for this role.

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