*Bilingual Claims Adjudicator (Insurance) — 100% Remote (MTL, QC)

<b>Bilingual Claims Adjudicator (Insurance)</b><br><b><br></b>Build your experience in the insurance industry by supporting the assessment and processing of health and dental claims within a fast-paced transformation project. This fully remote opportunity offers exposure to cloud-based systems, collaboration within a close-knit team, and strong potential for long-term career growth and professional development.<br><br><b>What is in it for you:</b><b><br></b><br>• Hourly salary of $19.<br>• 6-month contract with the potential for permanent employment.<br>• Full-time position: 37.50 hours per week.<br>• Schedule from 9 am to 5 pm.<br>• Enjoy the flexibility of remote work.<br><br><b>Responsibilities:</b><b><br></b><br>• Assess complex health and dental claims in accordance with contract provisions and established service standards.<br>• Review claims for completeness, enter and assess claim information, and determine payment responsibility after insurance benefits are applied.<br>• Make decisions that may impact member benefit entitlement and payable amounts.<br>• Manage assigned claims while prioritizing urgent cases effectively.<br>• Deliver high-quality customer service within established turnaround times.<br>• Communicate effectively with internal and external stakeholders to meet service expectations and support customer satisfaction.<br>• Contribute to financial efficiency and continuous improvement objectives.<br>• Support initiatives aimed at improving customer satisfaction and Net Promoter Score (NPS) results.<br>• Apply appropriate risk management tools and techniques in daily activities.<br>• Participate in projects focused on improving claims processing effectiveness and operational efficiency.<br>• Resolve claims-related issues and coordinate appropriate escalation when required, including claims adjustments and technical decisions.<br>• Support Business As Usual (BAU) activities during the transition from a legacy system to a cloud-based platform.<br><br><b>What you will need to succeed:</b><b><br></b><br>• Bachelor’s degree in Business or a related field.<br>• 0–2 years of professional experience.<br>• Experience reviewing and adjudicating insurance claims, including verifying policy coverage and determining eligibility for settlement, is an asset.<br>• Previous experience within the insurance, health care, call center, or data processing industries is an asset.<br>• Experience collaborating with legal, medical, or external service providers is an asset.<br>• Strong proficiency with Microsoft Office 365 applications.<br>• Strong analytical and detail-oriented skills, including the ability to review receipts, extract data, and accurately enter information.<br>• Excellent verbal and written communication skills for interacting with diverse audiences.<br>• Ability to work independently and collaboratively in a fast-paced environment.<br>• Strong customer service orientation and interpersonal skills.<br>• Ability to take initiative and manage priorities effectively.<br>• Bilingual in English and French to support communication with internal and external clients while maintaining high-quality customer service standards.<br><br><b>Why Recruit Action?<br></b><br>Recruit Action (agency permit: AP-2504511) provides recruitment services through quality support and a personalized approach. As part of the screening process, some applications may be reviewed using artificial intelligence tools. Only candidates who meet the hiring criteria will be contacted.<br><br>

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1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

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