Claims Advisor Jobs

Program: Employment Ontario

Location: Remote - ON

Who we’re looking for

Claims Advisor

Like WCG, you believe in the power of work to transform lives. As a Claims Advisor, you’ll be responsible for auditing and processing financial claims as part of WCG’s Quality Improvement Framework and WCG’s Funding Model Guidelines. You will work closely with the Lead, Claims Management and Quality Support Manager to ensure accuracy, compliance and continuous quality improvement. In this role, you will be required to maintain high levels of confidentiality pertaining to client records and financial information.

What you’ll do

• Process client and employer financial support claims and ensuring contractual and legislative requirements are met
• Develop a strong understanding of WCG’s contract, guidelines, policies, and process
• Answer inquiries from staff regarding claims and other administrative questions
• Provide support and guidance to staff regarding claims processing in line with contractual and guideline requirements
• Ensure quality assurance for claims/invoices processed by Service Provider staff
• Undertake standard and ad hoc data entry tasks
• Communicate any issues regarding ineligible claims in line with processes
• Protect the interests of the organization – identify and manage risks, and escalate non-standard, high-risk transactions / activities as necessary
• Keep abreast of emerging trends for claims assessment and flag these to the Lead, Claims Management
• Effective use of WCG’s Case Management System and other systems and databases
• Demonstrate flexibility to be able to change activities based on changing requirements and business needs
• Ensure discrepancies are handled appropriately and escalating issues when necessary; refer staff to appropriate team members or internal partners as appropriate

What you bring

• Understanding of the needs of a highly confidential environment
• Minimum 2-3 years’ experience in a similar role working in a service-oriented organization
• Ability to working in fast paced environment with changing workloads
• Ability to adapt to change
• Excellent organizational and time management skills
• Strong auditing background and data entry experience
• Detail oriented with a high level of accuracy
• Proficient in MS Office especially Excel and Word
• Results driven with creative approach to idea generation and problem solving
• Able to maintain composure during difficult and high-pressure situations

What we offer

• Comprehensive and flexible health and dental benefits
• Ongoing learning and development opportunities
• Competitive salary
• Knowledge of the Employment Services industry an advantage but not required
• Generous time off policy to encourage work/life balance
• A diverse and inclusive workplace with a track record of high employee engagement and teamwork
• Bilingual (English and French) an advantage but not required

For complete job requirements, see the full visit wcgservices.com.

WCG is strengthened by diversity. We are committed to achieving a workplace that is equitable and representative of Canada’s diverse population. We actively work to attract, develop, and retain employees from diverse and equity-deserving backgrounds who have exceptional ability and the desire to make a difference. We continuously strive to support individual needs and differences in a work environment that is built on inclusivity and respect for everyone.

WCG is committed to providing an accessible, barrier free recruitment and selection process. If contacted for an employment opportunity, please advise us if you require accommodation in advance of any part of the recruitment and selection process.