Spec Claims Examiner-11

1 week ago


Bengaluru, Karnataka, India Empower Full time

Grow your career with a growing organization


Whether they're helping people reach their long-term financial goals or providing personal wealth management strategies, every associate contributes to changing the lives of those we serve for the better.

When it comes to job satisfaction, that's hard to beat.

And from a personal satisfaction perspective, you'll enjoy the freedom to support causes that matter to you and experience a truly inclusive work environment.

Your future starts now.


As a part of our claims examiner team, you will have the opportunity to support our business by reviewing, investigating and assessing group health and dental benefit claims submitted by our plan members.

You will make payment decisions, and work to ensure your performance targets are met.

We offer competitive salary and bonus program that rewards your performance in achieving individual and team objectives. As well, an employee recognition program rewards exceptional performance.

In addition to salary, annual bonus, and employee recognition programs, you are entitled to a comprehensive benefit package, with options to personalize the benefits package to meet the needs of you and your family.


Accountabilities:

  • Review, investigate and adjudicate Canadian Health and Dental claims in accordance with Group policy contracts
  • Conduct follow up with health and dental service providers for incomplete claims information
  • Make accurate payment decisions according to adjudication guidelines
  • Living our values of Customer View; Integrity; Partnership; and Communities

Qualifications and Competencies:

  • Must be able to handle large volumes of work with a high level of accuracy
  • Well developed analytical skills
  • Must have excellent written and verbal communication skills
  • Proven organizational skills
  • Reliable team member with good attendance
  • Customer Service Focused
  • Ability to excel within a Purpose/Vision driven environment
Required relevant experience 1-3 Years


This job description is not intended to be an exhaustive list of all duties, responsibilities and qualifications of the job.

The employer has the right to revise this job description at any time.

You will be evaluated in part based on your performance of the responsibilities and/or tasks listed in this job description.

You may be required perform other duties that are not included on this job description.

The job description is not a contract for employment, and either you or the employer may terminate employment at any time, for any reason, as per terms and conditions of your employment contract.

We are an equal opportunity employer with a commitment to diversity. All individuals, regardless of personal characteristics, are encouraged to apply.

All qualified applicants will receive consideration for employment without regard to age, race, color, national origin, ancestry, sex, sexual orientation, gender, gender identity, gender expression, marital status, pregnancy, religion, physical or mental disability, military or veteran status, genetic information, or any other status protected by applicable state or local law.

**COVID

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