At a Glance
- Tasks: Review and adjudicate travel insurance claims while communicating in English and Portuguese.
- Company: Epic Health Solutions, a leader in innovative healthcare solutions.
- Benefits: Competitive salary, health benefits, paid time off, and RRSP match.
- Other info: Hybrid work environment with a commitment to inclusivity and career growth.
- Why this job: Join a dynamic team and make a real impact in the healthcare industry.
- Qualifications: 2-3 years of claims experience and bilingual in English and Portuguese.
The predicted salary is between 63000 - 77000 $ per year.
- Salary Range: CA$40,000.00 To CA$45,000.00 Annually
- Company Overview
Epic Health Solutions boasts over 35 years of experience in the healthcare industry, providing innovative solutions in an ever-evolving marketplace.
As part of an award-winning enterprise group, we're proud to support a global team of more than 500 employees dedicated to enhancing healthcare services.
Summary
We are seeking a detail-oriented, bilingual Claims Examiner to join our Travel Insurance team at Epic Health Solutions.
In this role, you will review, investigate, and adjudicate travel insurance claims while communicating professionally with insureds, brokers, and medical facilities in both English and Portuguese.
This position is essential to maintaining claims accuracy and supporting our operational goals.
Key Responsibilities
- Review, investigate, and adjudicate Travel Insurance claims (Medical, Trip Cancellation/Interruption/Delay, Baggage Loss/Damage/Delay) in accordance with policy terms and conditions
- Communicate effectively and professionally in both English and Portuguese with insureds, agents/brokers, medical facilities, and other stakeholders to collect documentation and explain claim status and decisions
- Analyze medical records and other supporting evidence to determine coverage and validity of claims
- Respond to claim inquiries and complaints from insureds and brokers in a timely, courteous manner
- Maintain accurate reserves and ensure timely updates to the claims management system
- Draft clear, accurate, and compliant claim denial letters that cite applicable policy language, in both English and Portuguese as needed
- Participate in quality reviews, training, and continuous improvement initiatives
- Perform other duties as assigned
Qualifications
- 2-3 years of experience in claims examining or adjusting insurance claims (Travel, Health, or related field)
- Bilingual fluency in English and Portuguese (spoken and written) required; must be able to professionally read, write, and speak with agents, medical facilities, and brokers in both languages
- Strong understanding of travel insurance policies and benefits considered an asset
- Excellent analytical, problem-solving, and decision-making skills
- Strong attention to detail and accuracy
- Strong written and verbal communication skills
- Ability to prioritize tasks and manage deadlines in a fast-paced environment
- Proficiency with MS Office
- Core Competencies
- Claims Adjudication
- Customer Service Excellence
- Accuracy and Attention to Detail
- Communication
- Time Management
- Accountability
- Problem Solving
- Teamwork
- Professionalism
- Job Type
- Full-time
- Expected Hours
- Schedule
- 8-hour shift, Day shift, Monday to Friday
- Work Location
- Hybrid
- Language Requirements
- English and Portuguese
- Dental care
- Employee assistance program
- Extended health care
- Life insurance
- On-site parking
- Paid time off
- RRSP match
- Accessibility
Epic Health Solutions is committed to providing an inclusive and accessible work environment and complies with the Accessibility for Ontarians with Disabilities Act (AODA).
We are dedicated to ensuring equal opportunities for all applicants.
If you require accommodations during the recruitment process, please email us at accessibility@epicamericas. com and we will work with you to meet your needs.
Claims Examiner in Markham employer: National Healthcare Solutions, Inc.
Epic Health Solutions is an exceptional employer that values its employees by fostering a supportive and inclusive work culture. With over 35 years in the healthcare industry, we offer competitive salaries, comprehensive benefits including dental care and life insurance, and opportunities for professional growth within our global team. Our hybrid work environment allows for flexibility while maintaining a strong commitment to employee well-being and development.
Contact Details:
National Healthcare Solutions, Inc. Recruitment Team
