Health Insurance Analyst

Posted:
8/21/2024, 1:37:17 PM

Location(s):
Ontario, Canada ⋅ Toronto, Ontario, Canada

Experience Level(s):
Junior ⋅ Mid Level ⋅ Senior

Field(s):
Customer Success & Support

Official Internal Job Title:

Health Insurance Analyst

Status:

Regular

Job Description:

Reporting to the Director, the Group Health and Dental Insurance Analyst analyzes specific problems and situations related to the management of Pan-Canadian Group Health and Dental Insurance plans; develops strategies intended to respond to our customers needs; provides the necessary support and guidance to the administration of group insurance plans and to adapt our claims procedures accordingly; has a strong knowledge of the Pan-Canadian group insurance market  and of the different Provincial healthcare programs related to the Health and Dental sectors; participates with our Toronto office team in meetings with clients, group or third party administrators, suppliers, to represent the Company.

JOB DUTIES

  • To analyze problems and situations related to Group Health and Dental insurance and to propose and develop solutions based on solid information gathering and that are adapted to the client needs.

  • To provide to our Health and Dental claims processing team all the necessary information about health and dental public plans in each provinces and territories.

  • To participate in the revision of documents, intended to members, group administrators, suppliers, third party administrators.

  • To put in place mechanisms allowing to collect complaints and comments from customers or third party administrators; to identify customers or third party administrators’ needs; to propose the necessary changes or modifications. 

  • To identify market requirements and how the Company can deliver on these requirements.

  • To work closely with our providers (ESI, Claim Secure, etc.) to make sure processes are being followed.

  • To provide support to our Toronto Customer Service team and to our Claims processing team on the resolution of claim issues.

  • To provide input regarding tools, systems and information available to our Toronto Customer Service.

  • To represent the Company at occasional Finalist Presentation and quarterly review meetings for large clients.

  • To provide or request, by telephone, interviews or by writing, information pertaining to departmental activities (suppliers, external clients, pharmacies, TPA’s, etc.).

  • To work with the Systems Development team and analysts, running interactive systems tests and participating in the acceptance of functional requirements.

  • To participate in group work organized within the Claims Processing Department.

  • To perform any other required tasks or duties.

RESPONSIBILITIES

  • To find effective solutions based on solid information gathering, followed by rigorous and logical analysis of such.

  • To effectively contact and deal with people, displaying an open communication style and honesty, while respecting the opinions of others.

  • To constantly strive for quality and excellence in the work methods, services provided and products being sold.

  • To be aware of early-warning signs of changes to come.

  • To ask appropriate questions that will help bring about the best possible results in the most cost-effective fashion.

  • To be able to work unsupervised, to follow independent lines and to carry out projects or activities self-sufficiently.

  • To back up ideas, projects, and goals with concrete actions.

  • To decide which messages to convey using appropriate language, drafted using clear and precise language.

  • To share ideas and projects for change, while ensuring that these are carried out.

REQUIRED SKILLS AND KNOWLEDGE

Education

  • Bachelor’s degree in Business Administration or in a relevant discipline

Experience

  • 7 years of experience in group health and dental insurance in the Canadian market

Requirements

  • Strong verbal skills.

  • Excellent command of spoken and written English.

  • Be familiar with software such as Excel, Word and Power Point.

  • Strong knowledge of the Provincial Healthcare Programs.

  • Functional French.

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Beneva is an equal opportunity employer, so we encourage all Women, persons with disabilities, Indigenous people as well as visible and ethnic minorities to apply.

Purpose : True to its purpose, Beneva places people at the heart of its actions and contributes to the well-being of the community. It accompanies its clients in all stages of their lives, both for their insurance and for their financial services.

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