Claims Analyst

Posted 19 Days Ago
Be an Early Applicant
Service, MS
In-Office
Junior
Fintech • Insurance • Financial Services
The Role
The Claims Analyst assesses and makes decisions on claims, ensuring compliance with policies, providing customer service, and training new staff.
Summary Generated by Built In

We’re looking for a Claims Analyst to join our Insurance Operations team at MBPS. In this role, you are responsible for the overall review, assessment, and decision on payment for claims.

Position Responsibilities:

  • Responsible for the complete assessment, calculation and final decision on claims (ex. Group life, AD&D, Survivor Income claims, TDMI, Personal Benefits as well as Compassionate Assistance Program loans.

  • Adjudicate and make independent decisions on non-contestable and contestable claims (i.e. Evidence of Insurability (E of I) and pre-existing conditions) within defined authority levels.

  • Operates within well-defined guidelines and processes/practices for routine claims. Identify invalid claims, detect fraud or misrepresentation and identify unusual facts to minimize liability of paying multiple claims Identify rival claim situations, take necessary steps and work with internal legal department for Payment into Court.

  • Review and interpret policy contracts, procedures and administrative systems to determine the total death benefit payable, tax implications and any continuing coverage options available.

  • Correspond with internal life moments team, beneficiaries, lawyers, advisors and executors on requirements and outstanding issues.

  • Provide on the job training to new approvers on non-contestable and contestable claims processing and procedures.

  • Responsible for communicating to internal partners as appropriate (i.e. Life Moments, Admin Advantage, Regional Group Offices (RGO.)

  • Ensuring excellence in customer service by answering questions of interested parties (internal/external) re processes/procedures prior to claims submissions (i.e. review of beneficiary designations, process/procedures etc.)

  • Responsible for identifying claims which fall within Unclaimed Property guidelines and following appropriate steps.

  • Dealing with conflicts effectively (i.e. beneficiary/advisor/ rival claim situations/internal partners challenging our request for medical, legal or claims requirements)

  • Ensuring proper requirements and service standards are met, especially when volumes are high Keeping current with new systems and products

  • Recognizing unusual or non-routine claims outside of procedures that require special investigation or handling

Required Qualifications:

  • Minimum of 2 years in a relevant back-office role, with at least 6 months of experience in voice call handling.

  • Familiarity in Microsoft Office (Excel, Word, Outlook).

  • Strong verbal and written communication skills.

  • College degree or equivalent business experience.

Preferred Qualifications:

  • Analytical and problem-solving skills, including strong attention to detail, to identify unusual claims and interpret policy contracts.

  • Good understanding of Insurance and claims systems and products

  • Familiarity with medical terminology (i.e. Assessment of covered losses under accidental dismemberment, CAP loans, Evidence of Insurability and pre-existing investigations, TDMI).

  • Knowledge of accounting, tax and legal implications relating to claims.

  • Excellent customer service skills and demonstrated empathy to deal with sensitive information and grieving customers

  • Organizational skills to be able to work in a high volume, fast-paced environment

When you join our team:

  • We’ll empower you to learn and grow the career you want.

  • We’ll recognize and support you in a flexible environment where well-being and inclusion are more than just words.

  • As part of our global team, we’ll support you in shaping the future you want to see.

About Manulife and John Hancock

Manulife Financial Corporation is a leading international financial services provider, helping people make their decisions easier and lives better. To learn more about us, visit https://www.manulife.com/en/about/our-story.html.

Manulife is an Equal Opportunity Employer

At Manulife/John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law.

It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process, contact [email protected].

Working Arrangement

Hybrid

Top Skills

Excel
MS Office
Outlook
Word
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The Company
HQ: Toronto, Ontario
32,427 Employees

What We Do

Manulife is a leading international financial services group that helps people make their decisions easier and lives better. With our global headquarters in Toronto, we operate as Manulife across our offices in Canada, Asia, and Europe, and primarily as John Hancock in the United States. We have more than 40,000 employees, over 116,000 agents serving ~34 million customers worldwide, and over $1.3 trillion in assets under management and administration.
Visit www.Manulife.com to find out more.

For Manulife terms of use, please visit http://bit.ly/SM_Terms

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