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Bilingual Claims Examiner
Department: Claims Administration
Reports to: Claims Administration Supervisor
Location: Richmond, BC
Who we are
TuGo is one of Canada’s leading travel insurance providers and a Canada’s Best Managed Company Platinum Club member. At TuGo, we make travel easier and a better experience by connecting partners and products with travellers, offering what they want, when, where and how they want it.
TuGo is an engaged, empowered and effective community of people, working together to help make great travel-related experiences for our customers. At TuGo we strive to be valued, effective and trusted. These values are the same internally in how we work with each other and externally expressed as our brand, in how we support and engage with our customers.
Headquartered in BC, with almost 200 employees in offices across Canada, we’re looking for a Bilingual Claims Examiner to join our Richmond, BC team!
What you'll do
After 6 months of training in our office in Richmond BC, this position can be performed remotely from home up to 4 days/week. You will process claim files according to Company policies and procedures. This involves reviewing claims, recommending payment or denial, or requesting additional information. You will process approved payments and/or denials for travellers and providers and set up payment requests from other insurers.
Specifically you will:
- Process claims according to Company policies and procedures. This involves reviewing claims for completeness and compliance with policy coverage and recommending acceptance or denial of claim and expenses.
- If claim requires additional supporting documentation to confirm payability, request and review medical history, medical records, itemized bill, etc. following established SOPs.
- Process payments and/or denials to travellers and/or providers.
- Set up requests for payment from provincial medical plans, extended health plans and any other insurers.
- Assist Customer Service Team by providing claim information to help resolve travellers’ phone and email inquiries.
- Provide backup and support for Medical Assistance Team for calls related to hospitalizations.
- On occasion, may act as liaison between TuGo’s medical staff and insured, family etc.
- Achieve performance targets.
- Collaborate and communicate effectively with team members and all other teams.
- Responsively and effectively handle issues.
- Look for ways to improve customer experience.
- Promote and model TuGo culture, values, and brand promise.
- Continuously build professional and technical expertise.
- Other duties as required.
What you'll bring
- Degree or Diploma in a business-related discipline
- Verbal and Written fluency in French & English
- Level 2 Insurance Adjuster’s license or Level 2 General Insurance License is an asset
- Ability to learn and apply knowledge of policy wordings to accurately process claims
- Strong analytical, problem solving and decision-making skills, detail-oriented and well organized
- Previous experience assessing claims is an asset
- Experience in customer service role is an asset
- Ability to multi-task
- Strong interpersonal, and conflict resolution skills
- Knowledge of medical terminology an asset
- Criminal record check is a requirement of the position as required by insurance councils for licensing
- Once fully trained, work schedule will include some non-business hour shifts (weekend and evening shifts)
- Strong team player and positive contributor
- Proficient in MS Office Suite and able to learn applications quickly
- Able to consistently live our values of valued, effective and trusted
- A strong customer experience focus
- A passion for continuous learning and professional achievement
Apply to TuGo
If you’re passionate about providing better customer experiences, and this position fits your career plan, send your resume and cover letter to: firstname.lastname@example.org
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