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Claims History Specialist

Job in Toronto, Ontario, M5A, Canada
Listing for: Manulife
Full Time position
Listed on 2026-02-17
Job specializations:
  • IT/Tech
Salary/Wage Range or Industry Benchmark: 51975 - 86625 CAD Yearly CAD 51975.00 86625.00 YEAR
Job Description & How to Apply Below

We are looking for a detail‑oriented and analytical Claims History Specialist to join our Claims team. In this role, you will ensure accurate and timely continuity of claims data—including drug history, DIN exceptions, and prior authorization statuses—to protect members from treatment interruptions and claim denials. You will play a direct role in improving the member experience and supporting Manulife’s mission of making decisions easier and lives better.

This opportunity offers the chance to build expertise in a specialized operational function while contributing to high‑impact client and member outcomes.

Position Responsibilities:

  • Load, review, and validate claims history using mainframe systems and automation tools.

  • Organize and scrub data files from multiple sources to ensure accuracy and system acceptance.

  • Coordinate with Implementation Managers to meet claims history requirements for onboarding, spin‑offs, and restructures.

  • Apply knowledge of health, dental, and drug claims programs to code DIN exceptions and manage continuity scenarios.

  • Ensure timely, accurate, and high‑quality processing to meet internal SLAs and reduce client impact.

  • Support proactive workflows that improve member outcomes and reduce rework.

  • Required Qualifications:

  • Experience in group benefits health and dental claims (typically 2–3+ years).

  • Strong Excel proficiency with experience cleaning, organizing, and validating datasets.

  • Demonstrated attention to detail and accuracy in data processing.

  • Post‑secondary education in a related field or equivalent experience.

  • Preferred Qualifications:

  • Experience coding DIN exceptions, reviewing drug histories, or handling prior authorization statuses.

  • Familiarity with mainframe systems used in claims processing.

  • Knowledge of Manulife systems, internal migrations, or onboarding processes.

  • Experience working with SOPs, QA frameworks, or SLAs.

  • Ability to adapt to complex workflows and evolving business requirements.

  • 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.

  • 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 .

    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 .

    Referenced Salary Location

    Waterloo, Ontario

    Working Arrangement

    Hybrid

    Salary range is expected to be between

    $51,975.00 CAD - $86,625.00 CAD

    If you are applying for this role outside of the primary location, please contact 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…

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