Medical Claims Examiner

Cambridge, ON, CA, Canada

Job Description

Join our team as a

Claims Examiner

and play a critical role in ensuring timely, accurate, and customer-focused resolution of insurance claims. You'll review and assess a wide variety of claims, make informed decisions in accordance with policy guidelines, and help deliver exceptional service to our clients.

What you will do

Review, analyze, calculate, and adjudicate a range of insurance claims to ensure they are processed in line with policy terms and service-level agreements.

Investigate claims by reviewing policies and utilizing internal systems to gather the necessary information for decision-making.

Accurately document claim files and maintain detailed notes in internal systems.

Handle payment adjustments including stop payment requests and reissue processing.

Proactively make outbound calls to customers and providers to obtain additional information required for claims resolution.

Respond to incoming calls, emails, and escalations regarding claim status or concerns, ensuring a professional and timely response.

Draft and send professional correspondence as needed.

Collaborate with internal departments to resolve customer issues and ensure claims are closed as efficiently as possible.

Manage claims reserves in accordance with internal guidelines and procedures.

Support efforts to close claims at first point of contact where possible, ensuring customer satisfaction and operational efficiency.

Leverage AI tools (e.g., ChatGPT or similar) to enhance productivity and streamline problem-solving.

What you will bring

Post-secondary education and 6-12 months of experience in a similar role (insurance, claims, or related field).

Strong attention to detail and the ability to manage multiple tasks simultaneously.

Excellent decision-making and problem-solving skills.

Proven ability to work independently and collaboratively in a fast-paced environment.

Strong written and verbal communication skills.

What we offer

Base Pay: $20.76 per hour CAD
Our employees play an integral part in our success as a business. We appreciate that each of our employees are unique and have unique needs, ambitions and we enjoy being a part of their journey.

We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of courses and targeted development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is key priority for us. This is why we build Work Well programs to providing you with peace of mind and give the flexibility in planning and arranging for a better work-life balance.

At Allianz we use some AI-assisted technology as part of our recruitment process to help match candidates to roles based on skills, experience, job title, and location. AI supports our recruiters by enhancing the efficiency and accuracy of candidate assessments and job recommendations, while all applications are reviewed by our recruitment team and final hiring decisions are made by humans.

Multiple vacancies may be filled from this job posting

Allianz Partners is a world leader in B2B2C insurance and assistance, offering global solutions that span international health and life, travel insurance, automotive and assistance. Customer driven, our innovative experts are redefining insurance services by delivering future-ready, high-tech high-touch products and solutions that go beyond traditional insurance.

Our products are embedded seamlessly into our partners' businesses or sold directly to customers and are available through four commercial brands: Allianz Assistance, Allianz Automotive, Allianz Travel and Allianz Care. Present in 75 countries, our 21,100 employees speak 70 languages, handle over 71 million cases each year, and are motivated to go the extra mile to offer peace of mind to our customers around the world.

At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. And the foundation for this is our inclusive workplace, where people and performance both matters, and nurtures a culture grounded in integrity, fairness, inclusion and trust.

We therefore welcome applications regardless of race, ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations.

Great to have you on board. Let's care for tomorrow.

Job Type: Fixed term contract
Contract length: 6 months

Pay: $20.76 per hour

Expected hours: 37.5 per week

Work Location: Hybrid remote in Cambridge, ON N3C 4N6

Expected start date: 2025-10-27

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Job Detail

  • Job Id
    JD2787318
  • Industry
    Not mentioned
  • Total Positions
    1
  • Job Type:
    Full Time
  • Salary:
    Not mentioned
  • Employment Status
    Permanent
  • Job Location
    Cambridge, ON, CA, Canada
  • Education
    Not mentioned