Claims Analyst - Group Benefit Claims (Hybrid)

Reporting to the Supervisor, TPA Claims, the Claims Analyst is responsible for the adjudication of medical claims in accordance with claim processing guidelines. We are seeking a dedicated and detail-oriented Group Benefit Claims Case management analyst to join our team. The successful candidate will be responsible for managing and processing group benefit claims, ensuring accuracy, compliance, and timely resolution. This role requires strong analytical skills, excellent communication abilities, and a commitment to providing exceptional service to our members.

What You Will Do

• Assess and process claims in accordance with company’s service standards, procedures,and insurance policy guidelines
• Obtain additional information needed to assess a claim - either through the provider orthe subscriber;
• Assist in identification and actualization of cost containment opportunities
• Handle claim enquiries ranging from basic to complex in nature
• Seek advice from designated team members on complicated cases or claims above authority limit
• Identify and investigate claims for possible abuse and fraud
• Utilizes all applicable system functions available ensuring accurate and timely claim processing service
• Escalate unresolved claims complaints and high costs claims to the supervisor for guidance
• Continually work to improve best practices procedures and standards
  
  

What You Will Bring

• Post-secondary diploma in a related field or equivalent training
• Minimum 1-2 years of experience in claims management or equivalent training, medical knowledge and experience, is an asset
• Strong attention to detail, organizational, time management and prioritization skills
• Demonstrate good judgement, reliability, and professionalism in fast paced environment
• Strong initiative, planning, and problem-solving skills, including an ability to focus on both details and results
• Excellent customer service skills and professionalism
• Comfortable working independently with minimal supervision
• Excellent written and verbal communication skills
• Bilingual, written and oral (English and French), is considered an asset
  
  

Who We Are

Proudly independent and Canadian-owned, Cowan Insurance Group has been a true market leader in the insurance industry since 1927. With an extensive range of product offerings and integrated commercial and personal insurance, group benefits, and wealth management solutions, we provide our clients with outstanding customized, comprehensive insurance and risk management professional advice and placement.

Recognized as one of Canada's Most Admired Cultures and a Canada's Best Managed Companies Platinum Club Member, Cowan Insurance Group's award-winning client-centric approach emphasizes innovation, excellence, and collaboration. Join our team as we prepare for our centennial celebration in 2027!

What sets us apart?

Be In Good Company

Integrity matters. It drives our award-winning workplace culture and fuels our collective desire to help our clients, employees, and communities thrive.

Challenge your thinking

You're valued for your passion, drive and creativity. The pace is fast but the work is meaningful, interesting, and complex, just the way you like it.

Grow together

We believe in your potential. If you’re looking to develop your expertise with learning opportunities and mentoring, we’ll make that happen.

Benefits And Perks

• Competitive salary
• Participate in our comprehensive benefits plan on day one — no waiting period
• Company-matched Retirement Savings Plan
• Company-paid training and development courses
• Community involvement
• Hybrid work environment
  
  

Are you interested?

Please Apply!

This position is subject to appropriate background checks that may include, credential, employment, credit, criminal and reference checks.

While we appreciate the interest of all applicants, we will contact only those selected for interviews. If you are an applicant with disabilities and require accommodations, please let us know at the time of our contact so that we may arrange for their provision.

We are an Equal Opportunity Employer. Employee candidates will be selected strictly on the basis of an individual's technical qualifications, knowledge and experience, as they relate to the requirements of a particular position. Selections will be made without regard to: race, ancestry, place of origin, colour, ethnic origin, citizenship, creed (religion), sex, sexual orientation, handicaps (physical or mental), age, marital status, family status, or the receipt of public assistance or record of offences.