Bilingual Medical Claims Administrator – Remote
Insurance role focused on claims analysis in both group and individual contexts, involving interactions with various stakeholders and medical professionals. This position offers a flexible remote work environment, benefits starting on day one, a stable schedule, and conditions that support work-life balance.
What is in it for you:
• Salary between 55K-65K, depending on experience.
• 4 weeks of vacation from the start of employment.
• 35-hour workweek, scheduled between 8:00 am and 5:00 pm.
• Full-time remote work with a required presence at the Saint-Hyacinthe office once per month.
• Group insurance from day one, including medical, dental, vision, travel, and roadside assistance coverage.
• Defined benefit pension plan equivalent to government plans, available after one year of service.
• Employee assistance program.
• Paid sick days.
• On-site fitness room.
• Social activities organized throughout the year, including BBQs, Christmas parties, and Halloween events.
• Various employee discounts, including the Saint-Hyacinthe privilege card and insurance products.
• Ongoing training opportunities.
• Recognition of years of service.
Responsibilities:
• Analyze group and individual insurance claims by evaluating medical evidence, contract provisions, government programs, and applicable legal aspects.
• Determine eligibility of claims and ensure proactive case management to optimize outcomes.
• Communicate with insured members, employers, brokers, providers, and healthcare professionals to gather relevant information for decision-making.
• Clearly and effectively communicate decisions and action plans to all stakeholders.
• Collaborate with medical consultants and rehabilitation teams in case follow-ups.
• Ensure compliance with established processing timelines and service standards.
• Participate in departmental activities and projects and support colleagues as needed.
What you will need to succeed:
• College diploma or university degree in a relevant field.
• Knowledge of legal or medical concepts is considered an asset.
• 2 years of experience in a similar role or a related field, including customer service.
• Excellent communication skills with a strong client-focused approach.
• Bilingual in English and French to support clients in both languages.
• Strong analytical and problem-solving skills with attention to detail.
• Strong interpersonal skills, empathy, and adaptability.
• Ability to work independently with strong organizational and time management skills.
• Proficiency in computer tools, including Word and Excel.
Why Recruit Action?
Recruit Action (agency permit: AP-2504511) provides recruitment services through quality support and a personalized approach. As part of the screening process, some applications may be reviewed using artificial intelligence tools. Only candidates who meet the hiring criteria will be contacted.
