Job Description

Job Summary

Provides professional services for life and dependent life, accidental death and dismemberment (AD&D), short-term and long-term disability and critical illness claims to clients and ensures claims meet contractual terms and conditions.

Supervisor: FNIS Plan Supervisor

Primary responsibilities

Coordination of all FNIS plan short-term and long-term disability claims, life and dependent life claims, AD&D and critical illness claims for Plan Members

Must verify and review claims and determine eligibility and accuracy prior to submitting to Insurance Carrier(s) for processing

Responsible to send application packages for short-term and long-term disability to plan members or plan administrators upon request

Responsible for processing FNIS plan life and dependent life claims. Claims specialist will work with Plan Administrator to provide all necessary forms and documentation required to complete the claim and forward to Insurance Carrier for processing. Support delivery of benefit payment to beneficiary(ies)

Responsible for processing FNIS plan AD&D claims. Claims specialist will work with Plan Administrator to provide all necessary forms and documentation required to complete the claim and forward to Insurance Carrier for processing. Support delivery of benefit payment to beneficiary(ies)

Responsible for processing FNIS plan Critical Illness claims. Claims specialist will work with Plan Administrator to provide all necessary forms and documentation required to complete the claim and forward to Insurance Carrier for processing. Support delivery of payment to Plan Members or beneficiary(ies)

Act as a liaison between the Plan Member, Plan Administrators, beneficiaries, and the Insurance Carrier(s), by providing updates and applicable correspondence to/from Plan Members, Plan Administrators, beneficiaries, and/or Insurance Carrier(s)

Compose, edit, and maintain documentation of correspondence (written and verbal), claims submissions, and claims progress for tracking and/or informational purposes

Responsible to run reconciliation reports or ad-hoc reports upon request

Respond to inquiries from Plan Members, Plan Administrators, beneficiaries, and the Insurance Carrier(s). Responsible to contact Plan Members, Plan Administrators, beneficiaries, and the insurance Carrier(s) to gain additional information when discrepancies occur

Filing of all FNIS plan short-term and long-term disability claims, life and dependent life claims, AD&D and critical illness documents (hard copy and electronically)

Responsible for the creation and maintenance of process and procedure notes applicable to the role

Other duties as required

Knowledge and skill requirements

Excellent communication skills internally and externally, i.e. Staff, Clients, Plan Administrators, Plan Members, the Insurance Carrier(s), Beneficiaries, and the General Public

Professionalism and confidentiality when dealing with highly confidential personal, financial, and medical information

Ability to problem solve to resolve concerns and identify matters that need to be escalated

Ability to work independently and as a team member

Ability to prioritize and multi-task

Knowledge of computers and software products

Organized, trustworthy, respectful, diplomatic, compassion, empathetic, sympathetic, and approachable

Demonstrate cultural competencies by displaying a set of values behaviours, attitudes, and practices individually, and within an organization, which enables them to work effectively cross culturally

Educational Requirements (Qualifications)

Office or Administration Diploma, or three years' experience working in an office environment

2 years group insurance experience is preferred

Business Admin Degree would be an asset

Life License would be an asset

General knowledge of group insurance, pension/savings plans, and/or individual insurance products would be an asset

Job Type: Full-time

Pay: $30.07-$33.15 per hour

Expected hours: 37.5 per week

Additional pay:

• Bonus pay

Benefits:

• Company pension
• Dental care
• Disability insurance
• Extended health care
• Life insurance
• Paid time off
• Vision care
• Wellness program

Schedule:

• Monday to Friday

Work Location: In person

Application deadline: 2025-02-23
Expected start date: 2025-03-17