Job Title:

Supervisor - Claims Services


First Canadian Health


Toronto, ON

Available: 2-Year Full-Time Contract

Salary: $60,000-70,000


Health Claims Administration processes manual claims for extended healthcare, dental and pharmacy benefits, including the claim referral process with dental consultants, and provides accurate claims adjudication within service levels. In addition, this department is responsible for investigating and responding to inquiries, and updating process documents to support the audit function. Health Claims Administration is also responsible for updating the dental and extended healthcare plan set up according to customer request and design.

We seek to hire a Supervisor, Claims Services reporting to the Manager, Health Claims Administration. As Supervisor, Claims Services you will provide support to internal and external customers. The supervisor provides leadership in the following areas: teamwork, operational excellence, performance management, change management, customer service and innovation. This job should directly contribute to building a higher performance culture.

Preferential hiring is given to candidates of Indigenous ancestry including status and non-status First Nations, Metis, and Inuit. We encourage applicants to include this information in their cover letter when applying.

Key Responsibilities:

  • Review the workflow within the unit daily
  • Work with the manager to identify productivity and process improvements
  • Escalate issues to the manager as required – identify risks and present solutions for optimizing results
  • Ensure claims turnaround time and productivity objectives are met based on service level standards
  • Ensure that team members are efficiently trained and provided with the appropriate tools to perform their jobs
  • Motivate, supervise and identify coaching/training opportunities for staff.  Provide ongoing feedback on a weekly basis and conduct annual performance reviews
  • Maintain various records and submit daily, weekly or monthly reports as required
  • Responsible for monitoring all filing on/off site (Iron Mountain Storage)
  • To track monthly Key Performance Indicators (KPI’s) statistics on turnaround times (TAT’s)
  • Support all internal Express Scripts Canada departments which rely on the daily operations of Claims Services
  • Manage the day-to-day claims processing operation according to established performance standards and documented NIHB policies and procedures for both French and English dental, medical supplies & equipment (MS&E) and pharmacy claims processing services
  • Track key metrics for reporting, communication, forecasting, staffing
  • Culture:  consistent practices, values, staff morale
  • Contributions of this role will assist Express-Scripts Canada in meeting Claims Processing SLA’s, maintaining customer satisfaction, optimize resource utilization and achieve operational excellence


  • Bachelor’s degree or equivalent work experience
  • A minimum of 5 years experience in group claims adjudication with a focus on health and dental claims with related leadership experience
  • Proven analytical and decision-making skills 
  • Knowledge of group benefits and claim administration 
  • Strong focus on customer service is required 
  • Ability to:
    • Work in French is not required, but is an asset
    • Identify opportunities for improvement and development of new ideas
    • Coach/train, give and receive feedback in a constructive manner
    • Build strong diverse teams
    • Think strategically
    • Adapt and prioritize workload
  • Excellent organization and planning skills 
  • Strong time management skills and ability to work under tight deadlines 
  • Strong presentation skills
  • Proven people management/leadership skills – ability to develop talent
  • Strong analytical skills
  • Working knowledge of Microsoft Office Suite of tools (Word, Excel, Outlook)
  • Performance management skills
  • Strong communication skills both verbal and written


Cover letter and resume can be emailed to:                     

Application Deadline: Open until filled.

Posted 2018-10-22

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