Bilingual Services Representative - Call Centre

Bilingual Benefits Services Representative - Call Centre Job Description

Who We Are
With every job, there’s always the question of “why”. Why join a company? Why be part of their mission? Here, the why is easy. It’s because at some point, we’ve all needed someone there for us.
At the OTIP Group of Companies (OGC), we believe that something special happens when employees feel valued for the work they do, supported as the people they are, and included in the very fabric of the organization: they bring their best to work every day. And that's why we mean it when we say we put our people at the centre of everything we do.

Join us as we grow our way into a future that reimagines what it means to deliver meaningful benefits support and service.

What You’ll Do:

Reporting to the Assistant Manager, Benefits Services, you’ll be responsible for handling incoming telephone inquiries within a call centre environment for all lines of group and individual life and health benefits. This involves providing benefits information and resolving member concerns and providing navigational support for our web and mobile app.

The core parts of your role will be to:

• Assist members with online registration and navigation for our web portal and mobile app.
• Educate members about OTIP’s products and services to ensure members’ needs are being fully met by OTIP.
• Provides timely and accurate information in response to incoming telephone inquiries using an automated telephone system, computer applications, training material and other applicable resources.
• Resolves member complaints regarding coverage, claims and service, and documents outcomes for future reference. This includes clarifying members’ complaints, investigating the problem, developing solutions, making recommendations to management, and following up to ensure resolution.
• Works with the carrier to process claim adjustment requests and cheque stop-payments, and reissues requests related to claims adjudication issues, while ensuring decisions are made on a timely basis. Identifies trends in claim adjudication errors and problems.
• Responds to member email inquiries from the department’s email queue within specified department turnaround times.
• Provides information in response to inquiries from members and other departments regarding coverage, effective dates, and outstanding information, as requested.
• Ensures a high level of customer satisfaction through effective support and excellent customer service, by providing quick and accurate service in a professional manor.
• Drafts letters and prepares and processes responses to routine correspondence, while adhering to established standards.
• Applies proper contractual provisions in accordance with related contracts and carrier requirements to determine member eligibility for requested benefits.
• Issues member confirmation notices in response to member telephone inquiries and prints the necessary documents, as required.
• Maintains historical records by filing documents and records of insurance transactions and maintaining master files, amendments, etc.
• Maintains a comprehensive log and diary system and reviewing and flagging all problem situations for discussion with management, as required.
• Keeps information confidential to protect operations.
• Performs other duties within competence, as assigned.

Let’s Talk

About You:

This is the unique blend of skills and experience we would love to see in an ideal candidate:

• A post-secondary school diploma.
• A minimum of one year’s post-secondary training in insurance-related courses such as LOMA, HIAA or CEBS.
• A minimum of one year’s experience in group health, dental and travel insurance.
• A minimum of one year’s experience in a call centre environment.
• Strong knowledge of group health, dental and travel…