Job Description

Job Summary

First Canadian Health is looking to hire a Bilingual Claims Supervisor reporting to the Manager, Health Claims Administration, for our partner and client, Express Scripts Canada. As the Bilingual Claims Supervisor, you will provide support to internal and external customers. The Supervisor provides leadership in the following areas: Teamwork, Operational excellence, Performance Management, Change Management, Customer Service and Innovation. This job should directly contribute to building a higher performance culture and living the values of Express Scripts Canada. Health Claims Administration processes manual claims for dental, medical supplies & equipment, pharmacy, vision care, and mental health counselling benefits, and provides accurate claims adjudication within service delivery standards. In addition, this department is responsible for investigating and responding to inquiries and updating process documents to support the claim verification function. Health Claims Administration is also responsible for updating the dental and extended healthcare plan set up according to customer request and design.

Preferential hiring is given to candidates of Indigenous ancestry including status and non-status First Nations, Metis and Inuit. We encourage applicants to include this information in their cover letter when applying.

Key Responsibilities:

Supervise, lead and develop a team of Claims Processors through workload management, regular performance reviews, day-to-day coaching Review the workflow within the unit on a daily basis Work with Manager to identify productivity and process improvements Escalate issues to Manager as required - identify risks and present solutions for optimizing results Ensure claims turnaround time and productivity objectives are met based on service level standards Ensure that team members are efficiently trained and provided with the appropriate tools to perform their jobs Work with Quality Assurance Analyst to address opportunities with quality Motivate, supervise and identify coaching/training opportunities for staff. Provide ongoing feedback on a bi-weekly basis and conduct goal check in's with staff Maintain various records and submit daily, weekly or monthly reports as required Responsible for monitoring all filing on/off site (Iron Mountain Storage) To track monthly Key Performance Indicators (KPI's) statistics on turnaround times (TAT's) Support all internal Express Scripts Canada departments which rely on the daily operations of Claims Services Manage the day-to-day claims processing operation according to established performance standards and documented NIHB policies and procedures for both French and English vision care, mental health counselling, dental, medical supplies & equipment (MS&E) and pharmacy claims processing services Track key metrics for reporting, communication, forecasting, staffing Culture: consistent practices, ESC values, staff morale Contributions of this role with assist Express-Scripts Canada in meeting Claims Processing SLA's, maintaining customer satisfaction, optimize resource utilization and achieve operational excellence

Qualifications

Bachelor's degree or related job experience Minimum of 3 years of proven leadership experience in a supervisory or team lead capacity, with a demonstrated ability to coach, develop, and motivate staff to achieve operational and strategic goals Minimum of 3-5 years experience in group claims adjudication with a focus on health and dental claims Bilingualism (French/English) / Bilingualism (French/English) is strongly preferred Proven analytical and decision-making skills Knowledge of group benefits and claim administration Strong focus on customer service is required Ability to identify opportunities for improvement and development of new ideas Ability to coach/train, give and receive feedback in a constructive manner Excellent organization and planning skills Strong time management skills and ability to work under tight deadlines Strong presentation skills Proven people management/leadership skills - ability to develop talent Ability to build strong diverse teams Strong Analytical skills Ability to think strategically Ability to adapt and prioritize workload Working knowledge of Microsoft Office Suite of tools (Word, Excel, Outlook) Performance management skills Strong Communication skills both verbal and written

Additional Skills:

Attention to detail and accuracy in work Basic knowledge of medical terminology is an advantage Previous experience in customer service or administrative roles is a plus but not required

This position provides a valuable opportunity to gain insights into the healthcare industry while developing essential skills for future career growth.

At First Canadian Health, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or another ground protected by applicable law.

It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and First Canadian Health policies.

For more information about First Canadian Health, and our parent company, Tribal Councils Investment Group, please visit:

https://firstcanadianhealth.biz

http://www.tcig.biz

Job Types: Full-time, Permanent

Pay: $70,000.00-$80,000.00 per year

Ability to commute/relocate:

Toronto, ON M4N 3N1: reliably commute or plan to relocate before starting work (required)
Application question(s):

There is a bona fide requirement of being granted security clearance through the Government of Canada for this position. Can you meet all of the following security clearance requirements: At least 18 years of age, Lived in Canada for the past 5 years, Able to clear a criminal record check? Preferential hiring is given to Indigenous candidates for this position, though it is not a requirement. Do you identify as an Indigenous person in Canada? Do you have any Supervisor experience, or skills from past employment that you feel would be useful for the position?
Language:

English and French (required)
Work Location: Hybrid remote in Toronto, ON M4N 3N1