Senior Benefits Adjudicator
7 days ago
About This Position
">This role is critical to ensuring the fair and accurate evaluation and decision-making processes for claims.
Main Duties:
">- ">
- Apply knowledge of policies and procedures to determine eligibility for benefits.">
- Make informed decisions on claims, considering relevant factors and timelines.">
- Collaborate with third-party administrators to review and approve recommendations and decisions.">
- Ensure accurate benefit payouts and checks align with policy requirements, laws, and regulations.">
- Work closely with the Claims Manager to address claims-related issues and concerns.">
- Communicate claim decisions with internal stakeholders and external parties as necessary.">
- Provide guidance and support to junior team members with complex claims outside their authority.">
- Identify and escalate potential fraudulent claims to senior leadership for guidance.">
- Maintain accurate and detailed records of claims, communications, and resolutions in our claims management system.">
- Participate in team projects and initiatives to drive business growth and improvement.">
What Drives Us
">This role will report directly to the Health Claims Senior Manager and be part of a collaborative team focused on delivering exceptional customer experiences.
">Key Qualities
">- ">
- We prioritize customer satisfaction, always looking for ways to improve our services.">
- We are passionate about innovation, embracing new approaches to drive business success and customer satisfaction.">
- We recognize the strength of diverse perspectives and ideas, valuing collaboration and effective communication.">
- We take ownership and accountability, focusing on results and continuous improvement.">
- We act with integrity, transparency, and respect in all our interactions.">
- We promote inclusivity and diversity, creating a workplace where everyone feels valued and empowered.">
Requirements and Qualifications
">- ">
- A minimum of three years' experience in life and health claims processing, insurance, or a related field.">
- Bachelor's degree in healthcare administration, business, or a related field preferred.">
- Relevant industry certifications or exams passed (e.g., FLMI).">
Benefits and Career Advancement
">- ">
- A competitive salary and benefits package designed to support your well-being and career growth.">
- A dynamic work environment that encourages learning, innovation, and teamwork.">
- A clear path for professional development and leadership opportunities.">
- Flexible work arrangements and a commitment to work-life balance.">
- Access to training programs and resources to enhance your skills and knowledge.">
About Manulife Financial
">Manulife Financial Corporation is a leading international financial services provider, helping people make informed decisions and improve their lives. To learn more, visit https://www.manulife.com/en/about/our-story.html.
">Our Commitment to Equality and Diversity
">We believe in the importance of diversity and inclusion in the workplace. Our goal is to create a workplace where everyone feels valued, respected, and empowered to contribute their best work. If you require accommodations during the application process, please let us know.
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