Bilingual Individual Disability Senior Case Manager

New

ManulifeInsurance claims

Source API remote eligibility restrictions: CanadaFull-TimeSenior

SalarySalary range is expected to be between $59 700,00 CAD - $99 500,00 CAD

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Job Details

Languages: Fully bilingual (French/English)
Experience: 3+ years of experience in claims adjudication, ideally in disability claims.
Required Skills: Microsoft OfficeCustomer serviceNegotiation

Have a university degree in any discipline or equivalent experience.
Have 3+ years of experience in claims adjudication, ideally in disability claims.
Be fully bilingual in French and English to communicate with clients from various jurisdictions outside Quebec.
Have advanced proficiency in Microsoft Office, including Word, Excel, and PowerPoint.
Bring strong customer service orientation and solid negotiation skills.
Have strong oral and written communication skills to interact with internal and external clients and service providers.
Have working knowledge of government legislation and legal precedents; knowledge of the Insurance Act and/or the Civil Code of Québec is an asset.
Have strong working knowledge of medical conditions and terminology.
Have experience interpreting and applying financial documentation and fair claims practices.
Have a good understanding of underwriting processes and strong analytical skills to assess conflicting information and evaluate risk.

Establish and maintain customer service for policyholders, agents, and marketing centers.
Manage ongoing claims by requesting medical or financial documentation and investigations, and consulting specialists as required.
Review claims and underwriting files for disclosure of medical history, exclusions, riders, and endorsements.
Administer policy enhancements, premium waivers, and other policy benefits.
Determine claim benefit eligibility and communicate decisions to stakeholders.
Document claim events and maintain accurate claim records in the system.
Obtain file information and review it against policy provisions to verify eligibility.
Maintain claim records to support accurate reserve calculations.

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