Claims Examiner

: Claims Administration
: Claims Administration Supervisor
: Richmond, BC

At TuGo, we’re committed to helping travellers and partners have better experiences. To sum it up: We help—however we can. That’s why we’re one of Canada’s leading travel insurance providers and a Canada’s Best Managed Company!

We’re a team of specialized experts, dedicated to first-class customer service and claims assistance. We’re looking for a Claims Examiner to join our team, in our Richmond, BC office.

TuGo is privately owned with headquarters in Richmond, BC. We have over 170 employees in offices across Canada.

  • Process claim files according to Company policies and procedures. This involves reviewing claims for completeness and compliance with policy coverage, and recommending acceptance or denial of claim.
  • Follow up with travellers/providers if claim requires additional information (e.g. medical history, medical records, itemized bills, miscellaneous information, etc.).
  • Process payments and/or denials to travellers and/or providers.
  • Set up request for payment from provincial medical plans and extended health plans as required. Tracks payments received and close file.
  • Provide claim information when needed in order to help resolve traveller inquiries.
  • Assist travellers to complete claim forms and answers any questions (e.g. how to make a claim, explaining status of existing claim and/or why a claim was denied).
  • Provide backup telephone support for Medical Assistance Department as required.
  • 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.

  • 1 to 2 years of post-secondary education in a business-related field of study
  • Level 2 Insurance Adjuster’s license or Level 2 General Insurance License preferred
  • Ability to learn and apply knowledge of policy wordings to accurately process claim files
  • Previous experience assessing claims an asset
  • Experience in customer service role an asset
  • Strong interpersonal, and conflict resolution skills
  • Well organized, very detail oriented, ability to multi-task
  • Knowledge of medical terminology an asset
  • Second language is an asset preferably French, Spanish, Mandarin, or Cantonese, with written and verbal fluency
  • Ability to pass a criminal record check as required by insurance councils for licensing
  • Once fully trained, work schedule will include some non-business hour shifts (weekend and evening shifts)
  • Excellent written and verbal English communication skills
  • Strong team player and positive contributor
  • Proficient in MS Office Suite and able to learn applications quickly
  • Well-developed analytical, problem-solving, and decision-making skills
  • Able to consistently live our values of being purposeful, achievement-oriented, cohesive, evolutionary and treating others as you want to be treated
  • A strong customer experience focus
  • A passion for continuous learning and professional achievement
  • A passion for travel

Comment soumettre sa candidature

Pour soumettre votre candidature, envoyez-nous une lettre de présentation et votre curriculum vitae:

Courriel

careers@tugo.com

Télécopieur

604-276-9409

Par la poste

Human Resources - Careers
TuGo
11th Floor - 6081 No.3 Road
Richmond, BC, V6Y 2B2

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