Claims Analyst

Job Description

The position involves analyzing insurance contracts and claims to ensure correct application of provisions, payment, denial, and benefit calculations. The role requires bilingual proficiency in English and French, accurate data entry into claim systems, thorough documentation of claim handling, adherence to insurance regulations, and meeting internal service level standards.

Responsibilities

• Analyzes insurance contracts to ensure provisions are applied correctly. Evaluates each claim for appropriateness of payment, denial, calculation of benefits, etc.
• Bilingual in English and French languages.
• Requests and reviews all necessary information to assess each claim.
• Communicates with the insured routinely to provide statuses and updates as needed.
• Accurately inputs pertinent information into the appropriate claim system and processes claims in a timely and efficient manner.
• Ensures claim handli...