Operations Specialist CAN
Calgary, AB, CA
il y a 1j

Job Description Summary

Under direct supervision this position is responsible for working in a team environment providing front line administrative and general office assistance on a daily basis to both internal and external customers supporting proper claim handling practices, including telephone customer service, financial transactions, collecting, inputting, reviewing and updating critical claim and financial information as well as other administrative duties and projects as assigned.

Primary Job Duties & Responsibilities

  • Customer Service :
  • Serving as a customer service representative for the Claim department by promptly and professionally addressing customer questions and concerns, which may include rental status calls, CAT support and appraisal contacts and providing additional administrative support as required.
  • Financial Self Assessment (FSA) Services :
  • Assessing reasonableness of data as well as identifying discrepancies, including reconciliations.
  • Assessing the effectiveness of financial controls.
  • Performing underlying controls and effectively communicating findings.
  • Preparing data entries in accordance with established standards.
  • Supporting statutory reporting requirements.
  • Multi-line Claim Operational Service :
  • Entering data, typing and copying forms and documents including claim diaries and notes.
  • Correcting wage statements.
  • Setting up new claims using Claim Platform.
  • Requesting police reports and medical records.
  • Printing documents from the Claim Platform electronic File Cabinet.
  • Reviewing medical bills for proper billing and coding.
  • Sending certified mail and overnight packages.
  • Maintaining paper and / or electronic documents in claim file folders or electronic file cabinet, ensuring accuracy and tidiness.
  • Using proper software, consistently move closed files to and from off-site storage.

  • Reporting Services :
  • Preparing, generating and reviewing monthly, quarterly, annual, and ad hoc reports, documents and presentations using the most effective technology.
  • May include updating basic data discrepancies identified in reports.
  • Using management information data to prepare line of business or financial reportting including : daily reports for claim professions from Claim Platform, escalation duty workflow reports and tracking tasks using Access.
  • Claim payments and expense processing :
  • Processing and issuing invoice, outside expense, attorney expense and centralized expense payments.
  • Processing cancelled checks, voided checks and credits, input outside manual checks, report inside manual checks and document activity on systems note screens, as required.
  • Ensure timeliness and accuracy of all check processing.
  • Enterprise Contributions :
  • Performing quality contacts to assist as a result of catastrophic claim events.
  • Creating efficiencies by recommending alternative workflows.
  • General Operations Functions :
  • Receiving, sorting, processing and distributing incoming mail. Researching for the appropriate recipient may be required.
  • Sorting checks, opening, date-stamping and securing.
  • Collecting and processing out-going mail including Fed Ex.
  • Photocopying, scanning and uploading to the virtual file cabinet.
  • Ordering, receiving and distributing supplies and / or equipment.
  • Minimum Qualifications

  • High School Diploma with one year of claims clerical support, office related or customer service experience.
  • Education, Work Experience, & Knowledge

  • College degree preferred and / or equivalent work experience.
  • Claim handling or customer
  • service experience a plus but not required.
  • Ability to work independently or function as a team member with increasingly limited
  • supervision.
  • Excellent telephone, customer service and communication skills
  • Strong time management skills and ability to prioritize daily assignments.
  • Must be highly organized with ability to handle multiple tasks simultaneously to meet
  • deadlines.
  • Strong attention to detail is a must
  • Proficient computer skills and ability to learn new applications in a department with the
  • most advanced and continually improving computer platforms.
  • Excellent verbal and written
  • communication skills required to manage customer service requests, provide information to
  • Claim professionals and to respond to oral and written instructions.
  • Proficiency in
  • Microsoft Office (Excel, Word and PowerPoint).
  • Working knowledge of Access a plus.
  • Comfortable with newer and emerging technology and tools.
  • Highly proficient at data entry.
  • Job Specific Technical Skills & Competencies

  • Competencies / Skills :
  • Accountability : Takes ownership and responsibility for actions and outcomes, performance and
  • results.
  • Analytical Thinking : Identifies current or future problems or opportunities, analyzes,
  • synthesize and compares information to understand issues, identifies cause / effect
  • relationships and explores alternative solutions to support sound decision-making.
  • Change Management / Resilience : Remains energized and focused in the face of ambiguity,
  • change or strenuous demands.
  • Communication : Demonstrates effective verbal, written, and listening communication skills.
  • Customer Focus : Provides service excellence to internal or external clients.
  • Judgment / Decision Making : Exercises sound judgment, makes decisions and commits to a
  • position.
  • Leveraging Differences : Works with and includes people from different backgrounds,
  • experiences, cultures, races, etc. and views those differences as assets to be leveraged to
  • accomplish business goals and objectives.
  • Relationship Management : Seeks out, builds, fosters and maintains productive relationships,
  • networks or alliances to meet goals and achieve results.
  • Teamwork : Works together in situations when actions are interdependent and a team is
  • mutually responsible to produce a result.
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