Claims Investigation Analyst
Manulife
full-time
Posted on:
Location Type: Hybrid
Location: Montreal • Canada
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Salary
💰 CA$45,900 - CA$76,500 per year
About the role
- Perform risk-based data profiling and analysis to identify trends and outliers for investigation
- Lead and support audit programs; coordinate, assess, and make decisions on investigations
- Take initiative and lead investigations to successful conclusions including preparation of complaints
- Conduct interviews with plan members, service providers, and others
- Create written audits and correspondence to various stakeholders
- Engage with internal contacts such as Customer Service, Legal, Medical Consultants, and external stakeholders
- Lead, support and implement key investigative projects
- Deliver presentations to clients
- Travel required including working outside core hours
Requirements
- University degree or equivalent work experience
- Knowledge of Group Benefits
- Knowledge of the Canadian healthcare environment, service delivery model and regulation
- CFE designation is an asset
- Knowledge of fraud and abuse risk and techniques to manage risk
- Strong research, problem-solving and decision-making skills
- Ability to manage contentious interactions with various stakeholders
- Excellent oral and written communication skills
- Intermediate data analysis skills with proficiency in Excel and other data mining software
- Demonstrated investigation skills with attention to detail
- Ability to be creative, critical and aggressive in managing audit and investigative activities
- Organizational skills and ability to manage multiple conflicting priorities
Benefits
- health, dental, mental health, vision insurance
- short- and long-term disability insurance
- life and AD&D insurance coverage
- adoption/surrogacy and wellness benefits
- employee/family assistance plans
- various retirement savings plans (including pension and global share ownership plan)
- financial education and counseling resources
- generous paid time off program including holidays, vacation, personal, and sick days
- full range of statutory leaves of absence
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
data profilingdata analysisinvestigation techniquesresearch skillsproblem-solving skillsdecision-making skillsattention to detaildata mining
Soft skills
initiativeleadershipcommunication skillsorganizational skillsability to manage contentious interactionscreativitycritical thinkingability to manage multiple priorities
Certifications
CFE designation