Claims Support Specialist - RQ01720

Duration: 3 months (high possibility of extension)

Location: Hybrid (3 days/week in office)

Note to Applicants: This role will require the review of materials of a highly sensitive nature, that may include descriptions of physical and sexual abuse, racism, self-harm, and other triggering materials. Applicants are encouraged to consider whether such topics will be significantly distressing or upsetting for them.

Seeking Claims Support Specialists to support a high-profile claim processing initiative, reporting directly to the Senior Manager of Advisory. Independent contractors in this role will work both autonomously and collaboratively within a fast-paced, structured team environment to ensure accurate, timely, and efficient claims processing, while also responding to claimant inquiries with empathy, professionalism, and a commitment to service excellence.

This position blends technical expertise with emotional intelligence, requiring professionals who can manage sensitive inquiries, process documentation with precision, and engage empathetically with claimants who may face barriers due to trauma, mental health challenges, or poverty. While the nature of the work is emotionally charged, it is also mission-driven, time-sensitive, and results-oriented.

Successful candidates will demonstrate strong communication, adaptability, and integrity, balancing empathy with efficiency to deliver high-quality claim resolutions. This is an opportunity to create meaningful impact while maintaining professionalism, discretion, and accountability in all interactions.

Skills:

• 1+ year of experience communicating with clients / patients / or stakeholders over the phone
• Experience in data entry
• Ability to speak an Indigenous language (i.e., Cree languages, Inuktitut, Ojibway etc.) is considered an asset
• Knowledge of Indigenous culture is an asset
• Proficiency in Microsoft Office suite including Outlook, Word, and Excel
• Experience using a VOIP / Internet phone service is desirable

Deliverables:

Primary Administrative Duties

• Managing Correspondence: Handle incoming and outgoing mail, email, faxes, and phone communications. Ensure calls, supports tickets and claims are processed promptly and directed appropriately.
• Data Entry & Verification: Enter, review, and verify data from electronic and paper forms into a standard database. Maintain accuracy and confidentiality in all input.
• Document Processing & Organization: Scan, file, and store sensitive materials securely. Organize physical and digital records to ensure efficient retrieval when needed.

Claimant Support & Communication

• Phone Assistance: Answer incoming calls in a professional and empathetic manner, assisting claimants and representatives with inquiries related to their claims and the claims process.
• Outbound Calls & Follow-ups: Contact class members to obtain necessary documentation, confirmations, or additional details required to process claims efficiently.
• Claim Status Notifications: Prepare and send notifications regarding claim status, review decisions, and next steps. Ensure information is conveyed clearly and respectfully.
• Multi-channel Communication: Engage with claimants and representatives through phone, email, fax, and mail to ensure consistent and transparent communication.

Ensuring Ethical & Professional Standards

• Maintaining Compliance: Ensure adherence to company policies, privacy laws, and regulatory requirements when handling claimant information.
• Delivering High-Quality Work: Maintain precision and attention to detail when processing claims, data, and correspondence.
• Handling Sensitive Interactions: Approach conversations with claimants and representatives with empathy, patience, and professionalism, recognizing the emotional weight of certain claims, while also meeting expectations of project deliverables and timelines.

Call Centre

Responsibilities:

• Respond to incoming calls with empathy, professionalism, and discretion.
• Provide accurate information about the claims process while strictly adhering to confidentiality protocols.
• Escalate high-risk or complex cases to appropriate internal channels as needed.
• Maintain detailed and objective call notes in the system for documentation and audit purposes.

Expectations:

• Emotional resilience in managing difficult conversations, potentially involving traumatic events.
• Maintain composure, neutrality, and supportive tone at all times.
• Ability to navigate the conversation to quickly provide an answer/resolution for the call.
• Adhere to scripting guidelines without sounding robotic-balancing compliance with a human touch.
• Attending regular debriefings and mental wellness check-ins.

Support Tickets

Responsibilities:

• Triage, assign, and resolve client or internal inquiries submitted via ticketing systems.
• Identify sensitive cases that may require escalation or prioritization.
• Ensure timely, respectful, and comprehensive responses are logged and tracked.

Expectations:

• Demonstrate discretion and thoughtfulness in written communication.
• Flag concerning trends or repeated issues to leadership for proactive intervention.
• Maintain accurate records and follow up on unresolved tickets within set timelines.
• Attending regular debriefings and mental wellness check-ins.

Claims Coding and Claims Quality Checks

Responsibilities:

• Code claim details based on policy documentation, accurately capturing sensitive or traumatic descriptions without alteration or bias.
• Conduct quality assurance checks to ensure completeness, accuracy, and compliance with internal and regulatory standards.
• Identify inconsistencies or red flags and raise them for investigation or review.

Expectations:

• Display strong attention to detail and maintain zero tolerance for errors or assumptions.
• Handle potentially distressing content with professionalism and without personal judgment.
• Contribute to continuous improvement by providing feedback on coding inconsistencies or process gaps.
• Maintain psychological safety by taking breaks and utilizing support resources as needed.
• Attending regular debriefings and mental wellness check-ins.