Specialist Claims Quality Assurance

Aon Hewitt has announced BCAA as a 2019 Platinum Level Best Employer! 

What BCAA offers you:

  • It’s not in our nature to brag but we are proud of some of our achievements that recognize great employee culture. Some of our latest awards include being a 2019 Platinum level Best Employer by AON and being recognized as a 2018 Outstanding Workplace by YWCA.
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  • We pride ourselves in being open and transparent and in empowering our people to do great work while serving our Members. 
  • We enthusiastically support learning and advancement opportunities for our team members.
  • We are an equal opportunity employer that’s committed to accessible, inclusive employment. 
  • Our Regular Full-Time & Part-Time+ (working 20 hours or more per week) status team members are eligible to participate in our amazing Total Rewards Program which offers: Extended Health and Dental, Vision Care, Life Insurance, RRSP matching with company contribution to your pension, access to Incentive Programs, Team Profit Sharing, Employee & Family Assistance Program and more.
  • Team members at our Home Office also get to use our Shared EV (electric vehicle) Program, have access to our subsidized cafeteria and free fitness centre.

 

Our Claims department is hiring a Regular Full-time Specialist Claims Quality Assurance. The Specialist Claims Quality Assurance provides quality oversight, ensures consistent file handling and a superior member experience provided by the entire Claims Department. In addition, the role is responsible for providing comprehensive, timely and effective feedback to claims staff on file handling protocols and member interactions. The role will play an integral function in ensuring claims procedures are adhered to, appropriate risk management tools are utilized and a best in class member experience is achieved.

Key Responsibilities:

Operations:

1) Accountable for the Claim Department’s Quality Program:

a. Drafts quality assurance policies and procedures
b. Interprets and implements quality assurance standards
c. Reviews claim files to ensure adjuster/examining file handling meets the Claims Department handling guidelines and requirements
d. Reviews telephonic interactions between claim staff and members/customers to ensure best in class member experience is being delivered
e. Evaluates review results and provides coaching and mentoring to claims team members to ensure consistent claim handling and member interactions
f. Assures ongoing compliance with quality and department process and procedures
g. Analyzes data to identify areas for improvement in the Quality Program
h. Develops, recommends and monitors proactive strategies that ensure consistent, member focused and financially prudent claim handling
i. Prepares reports to communicate the outcomes of the Quality Program

2) Provides all claim related training to ensure a continuous learning and improvement process:

a. Identifies training needs and organizes training interventions to meet the needs of the Quality Program
b. Liaise with Corporate Training and Development to ensure Claims training aligns with Corporate training
c. Determines needs assessments and training opportunities which include establishing training and development plans.
d. Assists in the development of training materials and training assessment tools as well as reinforcing concepts
e. Consults with management to strategize training road maps
f. Participates in the development and execution of training assessment tools
g. Learns and maintains thorough working knowledge of all pertinent processes, policies, and procedures within the department

Qualifications:

• Education:

o University degree in a related field
o CIP or FCIP (preferred); or
o Combination of relevant industry experience and education

• Experience:

o 7 years in a Quality Assurance role with varying degrees of responsibility and autonomy
o 3-5 Claims Adjusting (preferred)

• Other Skills:

o Proven problem solving and organizational skills
o Demonstrated focus on providing excellent customer service
o Proven ability to perform multiple tasks and projects
o Demonstrated proficiency in Quality Assurance tools, concepts and methodologies
o Demonstrated high attention to detail with superior accuracy and completeness of processes
o Proven ability to work efficiently with exceptional time-management skills
o Demonstrated analytical skills, problem solving, decision making, and negotiation skills
o Intermediate knowledge of MS Office Suite (Word/Excel/PowerPoint