Bilingual Claims Investigation Analyst

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5 Locations
In-Office
Fintech • Insurance • Financial Services
The Role

Manulife’s Customer Experience Investigation Services department, an industry leader in fraud prevention, is looking for a dynamic individual to join its team.  This department is dedicated to preventing, detecting and investigating incidences of fraud and abuse against its benefit plans.


The Bilingual Investigation Analyst, Investigation Services is responsible for applying Group Benefits knowledge, attention to detail, problem solving abilities, customer service, investigation and data analysis skills to identify, investigate and prevent fraud and abuse. Additionally, this role will support the Manager with projects and initiatives.



Position Responsibilities:

  • Perform risk-based data profiling and analysis to identify trends and outliers in various categories for further review and investigation 

  • Lead and support audit programs; coordinating, assessing, and making decisions on investigations     

  • Take initiative and lead investigations to successful conclusions including the preparation of criminal and regulatory complaints

  • Conduct interviews with plan members, providers of service and others              

  • Create written audits and other correspondence to plan members, providers of service and others

  • Engages, interacts and consults with various internal contacts such as Customer Service, Legal, Client Relations, Medical Consultants, Regional Group Office and external stakeholders such as Health Practitioner Regulatory Bodies, Colleges and Associations, and Plan Sponsors 

  • Lead, support and implement key investigative projects

  • Comfortable delivering effective presentations to new and existing clients

  • Travel is required for this role, including the ability to work outside of core working hours



Required Qualifications:

  • Bilingual (French & English) is required - The successful candidate will be required to communicate in English and French in order to support clients from various jurisdictions outside of Quebec.

  • University degree or equivalent work experience


Preferred Qualifications:

  • Knowledge of Group Benefits

  • Knowledge of the Canadian healthcare environment, service delivery model and regulation     

  • CFE designation is an asset       

  • Knowledge of fraud and abuse risk, and techniques to manage risk 

  • Strong research, problem solving and decision-making skills 

  • Ability to manage contentious interactions with various stakeholders 

  • Excellent oral communication (both phone and face to face) and written communication skills  

  • Intermediate data analysis skills with expertise using Excel and other data mining software 

  • Demonstrate investigation skills with attention to detail  

  • Ability to be creative, critical and aggressive in managing audit and investigative activities

  • Organizational skills and the ability to manage multiple conflicting priorities



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.

#LI-HYBRID

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].

Referenced Salary Location

Montreal, Quebec

Working Arrangement

Hybrid

Salary range is expected to be between

$45,900.00 CAD - $76,500.00 CAD

If you are applying for this role outside of the primary location, please contact [email protected] for the salary range for your location. The actual salary will vary depending on local market conditions, geography and relevant job-related factors such as knowledge, skills, qualifications, experience, and education/training. Employees also have the opportunity to participate in incentive programs and earn incentive compensation tied to business and individual performance.

Manulife offers eligible employees a wide array of customizable benefits, including health, dental, mental health, vision, short- and long-term disability, life and AD&D insurance coverage, adoption/surrogacy and wellness benefits, and employee/family assistance plans. We also offer eligible employees various retirement savings plans (including pension and a global share ownership plan with employer matching contributions) and financial education and counseling resources. Our generous paid time off program in Canada includes holidays, vacation, personal, and sick days, and we offer the full range of statutory leaves of absence. If you are applying for this role in the U.S., please contact [email protected] for more information about U.S.-specific paid time off provisions.

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The Company
HQ: Toronto, Ontario
32,427 Employees
Year Founded: 1887

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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