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
- 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)
- 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:
Par la poste
Human Resources - Careers
TuGo
11th Floor - 6081 No.3 Road
Richmond, BC, V6Y 2B2
