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- Tasks: Assist clients with inquiries and process claims efficiently in a dynamic environment.
- Company: Innovative TPA/TPP focused on enhancing health benefits experiences.
- Benefits: Comprehensive benefits package, including health care, dental, and wellness programs.
- Why this job: Join a tech-driven team making a real difference in the benefits industry.
- Qualifications: 3 years in insurance or group benefits, strong interpersonal skills, and attention to detail.
- Other info: Full-time role with opportunities for growth and a supportive team culture.
The predicted salary is between 36000 - 60000 £ per year.
Location: Ayr, ON
Job Type: Permanent, Full-Time
Who are we:
We’re a Kelowna based Third Party Administrator/Payor (TPA/TPP) improving the health benefits experience for employers, insurers and, well, everybody! Our team leverages digital-focused strategies to provide members with fast, easy and thoughtful benefits experiences. To put it simply, we provide group benefits plans, but we’re a technology company first. Our team embraces autonomy, complexity and a connection between effort and reward as three qualities that foster a truly satisfying career and strive to separate ourselves from the corporate herd.
What we’re looking for:
We’re looking for a dynamic Client Service & Adjudicator Representative with a minimum of 1 year’ experience in the Benefits industry. They are responsible for handling client inquiries and processing claims in a timely and efficient way. They will be knowledgeable enough to walk clients through the member portal, understand plan designs and as well as providing claims processing assistance to the Support team!
What you’ll do:
- Interpret related Benefit policies and procedures and support compliance with government and provincial regulations.
- Process claims and predeterminations accurately in a timely manner within established service standards.
- Answer phone calls and assist members and providers with claim/coverage inquiries.
- Take ownership and resolve client issues and concerns to the satisfaction of the client and business unit, including but not limited to interacting with customers in a customer service capacity.
- Navigate the system to efficiently answer questions around coverage, members profiles, and where needed escalate issues to the corresponding team.
- Refer to questionable/contentious claims for evaluation as needed and provide recommendations for action to help minimize fraud.
- Contribute to the continuous improvement of business processes.
- Ensure data accuracy, integrity and consistency across designated databases.
- Perform additional basic tasks within the Support Team as required.
What you need:
- Must have a minimum of 3 years in an insurance company, group benefits role.
- Exceptional interpersonal skills to build positive relationships with our clients.
- Attention to detail and maintaining accurate client files.
- Capable of interpreting and applying claim guidelines while working through ambiguous situations.
- Dedicated team player with the ability to take the initiative, be independent with a positive attitude and dedication to quality and accuracy.
- Highly organized, accurate and detail oriented; well-developed ability to perform complex mathematical calculations.
- Strong organizational skills including the ability to prioritize and multi-task.
- Certification: None required although GBA or Group Benefits Certification would be considered an asset.
- A good understanding of personal computers and software, particularly MS Word, Excel, Outlook and G Suite.
What we can offer:
- Group Benefits Plan
- In Office Job Type: Full-time, Permanent
- Dental care
- Employee Assistance Program
- Extended health care
- Life insurance
- Paid time off
- Wellness program
Schedule: 8-hour shift – Shift schedule could be anywhere from 8 am to 12pm start time depending on the business need at time of hire.
Client Services and Adjudicator Representative in Ayr employer: Simply Benefits Inc.
Contact Detail:
Simply Benefits Inc. Recruiting Team
StudySmarter Expert Advice 🤫
We think this is how you could land Client Services and Adjudicator Representative in Ayr
✨Tip Number 1
Get to know the company inside out! Research their values, mission, and recent projects. This way, when you get that interview, you can show them you’re not just another candidate but someone who genuinely cares about what they do.
✨Tip Number 2
Practice your pitch! You want to be able to explain why you’re the perfect fit for the Client Services and Adjudicator Representative role in a clear and confident way. Think about your past experiences and how they relate to the job description.
✨Tip Number 3
Network like a pro! Reach out to current or former employees on LinkedIn. Ask them about their experiences and any tips they might have for you. Plus, it shows you’re proactive and really interested in the company.
✨Tip Number 4
Don’t forget to follow up after your interview! A quick thank-you email can go a long way. It’s a chance to reiterate your interest in the role and remind them why you’d be a great addition to their team.
We think you need these skills to ace Client Services and Adjudicator Representative in Ayr
Some tips for your application 🫡
Tailor Your Application: Make sure to customise your CV and cover letter for the Client Services and Adjudicator Representative role. Highlight your experience in the benefits industry and any relevant skills that match what we're looking for. This shows us you’re genuinely interested!
Show Off Your Skills: Don’t be shy about showcasing your exceptional interpersonal skills and attention to detail. We want to see how you’ve built positive relationships with clients in the past and how you’ve handled complex situations. Give us examples!
Be Clear and Concise: When writing your application, keep it clear and to the point. We appreciate well-structured applications that are easy to read. Avoid jargon unless it’s relevant to the role – we want to understand your experience without any confusion.
Apply Through Our Website: We encourage you to apply directly through our website. It’s the best way for us to receive your application and ensures you’re considered for the role. Plus, it gives you a chance to explore more about who we are and what we do!
How to prepare for a job interview at Simply Benefits Inc.
✨Know Your Benefits Inside Out
Make sure you brush up on your knowledge of group benefits and insurance policies. Familiarise yourself with common claims processes and the member portal, as you'll likely be asked to explain these during the interview.
✨Show Off Your Interpersonal Skills
Since this role involves a lot of client interaction, be prepared to demonstrate your exceptional interpersonal skills. Think of examples where you've built positive relationships or resolved client issues effectively.
✨Be Detail-Oriented
Attention to detail is crucial in this role. During the interview, highlight your ability to maintain accurate client files and perform complex calculations. You might even want to bring examples of how you've ensured data accuracy in past roles.
✨Prepare for Scenario Questions
Expect questions that put you in ambiguous situations related to claims processing. Practice how you would handle these scenarios, focusing on your problem-solving skills and ability to take initiative while maintaining a positive attitude.
