Healthcare Assessment Claims

About the role

Manulife is hiring for a Healthcare Assessment Claims position. The role covers the full claim process, from adjudicating non-complex claims to making disbursements to the correct beneficiary, and involves collaboration with field and head office colleagues.

Key responsibilities

• Manage all aspects of the claim process and adjudicate non-complex claims according to established guidelines, standards and state legislation.
• Analyze claim documentation, policy contract wording and in-force policy documents to determine completeness, validity, correct death benefit and correct beneficiary.
• Make claim decisions within approval limits and disburse on valid claims to the right beneficiary for the right amount.
• Handle claim-related issues such as check stop pay and reissue, and adapt to changing regulatory requirements.
• Process accounting as required and assist with workflow and system issues.
• Communicate with claimants or their legal representatives when needed and report suspected fraud to the appropriate sources.
• Take part in claims department projects and other duties as assigned.

Required profile

• Post-secondary education or equivalent work experience.
• May require LOMA 280, 290 (or obtained within 12 months of hire).
• Sound knowledge of the claims function, including claims, in-force administration and imaging/workflow systems.
• Sound knowledge of insurance beneficiaries, insurance contract law and state legislative requirements, and of company plans, riders and benefits.
• Basic knowledge of reinsurance and claim accounting.

Required skills

• Sound organizational, communication and interpersonal skills.
• Sound analytical skills and ability to prioritize under deadlines.
• Ability to comprehend and apply technical information to daily work.
• Knowledge of the mainframe and PC environment.

The working arrangement is hybrid. Manulife is an Equal Opportunity Employer and offers a flexible environment focused on well-being and inclusion.