Securian Canada

Claims Specialist

• Responsible for assessing claims for benefit by reviewing contractual, medical, and functional information and in accordance with certificate provisions, adhering to established routines and processes for our various clients;
• Follow up with diligent communications with the different stakeholders, to obtain or provide information regarding claim status and reasoning, and complete reporting as required;
• Thoroughly document the analysis according to Securian’s policies and processes;
• Effectively manage an active caseload in accordance with client service standards and best practice guidelines and established KPI’s and TAT’s;
• Contribute to and foster a positive and dynamic working environment by supporting team members and through collaboration to department project work, and with plan members, plan sponsors and other stakeholders, to ensure service standards are met;
• Learn and apply tools and technology that support continuous improvement by identifying opportunities to improve processes and customer service delivery and adapting to changes as improvements are implemented;
• Perform other related duties, as assigned.

Claims Examiner – 18 months contract

Claims Examiner, 18 months contract

Bilingual

• Effectively manages case/claims assignments and responds to inquiries from claimants regarding claim status and/or requests for claim forms.
• Manages the initial stages of screening claims.
• Applies an excellent understanding of certificate and policy provisions.
• Sets-up claims, including verifying policyholder information, policy effective date, premium status, and verification of claim eligibility and including ensuring appropriate claim forms are delivered to claimant.
• Communicates with key stakeholders including claimant, business partners, plan sponsors, physician, employers, verbally and/or in writing. Handles a variety of inquiries varying in complexity.
• Ensures compliance with Quality Assurance requirements and procedures
• Maintains compliance all KPI’s, standards, controls, policies, and practices as an active participant in the Company’s Information Privacy and Security Program.
• Perform other duties as assigned.

Claims Examiner – 18 months contract

Claims Examiner, 18 months contract

Bilingual Claims Care Representative