Find a job 
Featured Companies 
Featured Universities 
For Companies At a Glance
- Tasks: Provide excellent customer service and process health and drug claims efficiently.
- Company: Innovative TPA/TPP focused on enhancing health benefits experiences.
- Benefits: Comprehensive benefits package, including health care, dental, and wellness programs.
- Other info: Dynamic work environment with opportunities for growth and development.
- Why this job: Join a tech-driven team making a real difference in the benefits industry.
- Qualifications: 3 years in insurance with experience in adjudicating health and drug claims.
The predicted salary is between 36000 - 60000 £ per year.
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 Group Benefits Health and Drug Adjudicator Representative with a minimum of 3 years’ 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: The Group Benefits Health and Drug Adjudicator Representative will provide excellent customer service to our clients. This will include but is not limited to:
- 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.
- Ability to 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.
- 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.
- Must have a minimum of 1 year experience adjudicating health and drug claims.
- 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.
Group Benefits Health and Drug Adjudicator in Ayr employer: Simply Benefits Inc.
Contact Detail:
Simply Benefits Inc. Recruiting Team
StudySmarter Expert Advice 🤫
We think this is how you could land Group Benefits Health and Drug Adjudicator in Ayr
✨Tip Number 1
Network like a pro! Reach out to your connections in the benefits industry and let them know you're on the hunt for a Group Benefits Health and Drug Adjudicator role. You never know who might have the inside scoop on job openings or can put in a good word for you.
✨Tip Number 2
Prepare for those interviews by brushing up on your knowledge of claims processing and benefit policies. We want you to feel confident when discussing your experience and how it aligns with what we do at StudySmarter. Practice common interview questions and think about how you can showcase your interpersonal skills!
✨Tip Number 3
Don’t forget to follow up after your interviews! A quick thank-you email can go a long way in showing your enthusiasm for the position. It’s also a great opportunity to reiterate why you’re the perfect fit for the Group Benefits Health and Drug Adjudicator role.
✨Tip Number 4
Apply through our website! It’s the best way to ensure your application gets seen by the right people. Plus, it shows that you’re genuinely interested in joining our team and contributing to the awesome work we do in improving health benefits experiences.
We think you need these skills to ace Group Benefits Health and Drug Adjudicator in Ayr
Some tips for your application 🫡
Tailor Your Application: Make sure to customise your CV and cover letter for the Group Benefits Health and Drug Adjudicator role. Highlight your relevant experience in the benefits industry and any specific 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. Use examples from your past roles to demonstrate how you've built positive relationships with clients and handled complex situations. We love seeing real-life applications of your skills!
Be Clear and Concise: When writing your application, keep it clear and to the point. Avoid jargon and make sure your sentences are easy to read. We appreciate straightforward communication, especially since you'll be helping clients navigate their benefits!
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, especially health and drug claims. Familiarise yourself with common policies and procedures, as well as any recent changes in regulations. This will help you answer questions confidently and show that you're serious about the role.
✨Show Off Your Customer Service Skills
Since this role involves a lot of client interaction, be prepared to discuss your previous experiences in customer service. Think of specific examples where you resolved issues or improved a client's experience. This will demonstrate your interpersonal skills and ability to handle challenging situations.
✨Be Ready for Technical Questions
Given the tech-focused nature of the company, expect questions about your familiarity with software like MS Word, Excel, and G Suite. Brush up on your technical skills and be ready to discuss how you've used these tools in past roles to improve efficiency or accuracy.
✨Demonstrate Your Organisational Skills
This position requires strong organisational abilities, so come prepared to talk about how you manage your workload. Share strategies you use to prioritise tasks and ensure accuracy, especially when dealing with complex claims. This will highlight your attention to detail and ability to multitask effectively.