Digital Health and Dental Claims, Fraud and Loss Prevention – Senior Manager

Comma Recruitment are looking for a strong technologically adept claims leader to join our growing team.

This role will be located in Etobicoke and report to the Director, Health & Dental Benefits Support.  The Health & Dental Claims team is made up of 35-40 total team members and supervisors and will all report into this role.

• Lead a team of Supervisors to get the most out of their people and improve the technology they use to fulfill the expectations of their role.
• Design and execute a plan to protect our client’s benefits investment by addressing fraud, waste and minimizing financial errors.
• Identify and respond to opportunities that will increase the percentage of claims that are administered digitally.
• Partner with the Director to develop a service strategy and organizational structure that improves the client experience.
• Develop strong business relationships with internal sales and service partners that depend on the delivery of a “best in class” claims experience.
• Build a team of Health & Dental Claims Experts that process claims accurately and solve problems quickly and professionally.

A great fit for this role will have skills and experience that resonate with the following statements:

• Brings a “Digital First,” modern mindset and approach to claims adjudication
• Advanced knowledge of highly effective claims adjudication processes and applications and a track record of developing technology and processes to drive efficiency, accuracy and improve the client experience.
• Possesses first-hand knowledge of “before the claim arrives” fraud and waste prevention strategies.
• Leads their people and creates a culture that understands how they can positively impact the client experience. Emulates that mindset.
• Data driven decision maker. If the data doesn’t exist, knows how to create it.
• Focused on achieving service and quality targets and standards.

Qualifications

• 8 plus years progressive experience in the group benefits industry. A focus on health & dental claims and applicable regulatory standards and best practices
• Minimum of 5 years of leadership experience with at least 1 year of that experience at a comparable level of responsibility to this role as well as leading people managers
• Industry designation in employee benefits (e.g. CEBS) is an asset

Comma Recruitment are interviewing now for this full-time permanent position,  the role offers competitive salary and benefits, bonus, pension and group RRSP plans.

Please forward resume to [email protected]