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Health & Dental Claims Specialist

Date: Mar 31, 2021

Location: Winnipeg, MB, CA, R3C-1A8 Moncton, New Brunswick, CA, E1E-4R5 Toronto, ON, CA, M2P-2B7 Vancouver, British Columbia, CA, V6J-4Y3 Calgary, AB, CA, T2R-0E4 Edmonton, AB, CA, T6E-6A8

Company: Wawanesa Insurance


Wawanesa Mutual Insurance is one of the largest property and casualty insurers in Canada with $3 billion in annual revenues and assets of more than $9 billion. Wawanesa Mutual, founded in 1896 with executive offices in Winnipeg, is the parent company of Wawanesa General, which offers property and casualty insurance in California and Oregon, and Wawanesa Life, which distributes life insurance products and services throughout Canada. With over 3,500 employees, Wawanesa proudly serves over two million policyholders through nine regional offices and 41 service offices in Canada and the United States.  Wawanesa actively gives back to organizations that strengthen communities where it operates, donating well above internationally recognized benchmarks for excellence in corporate philanthropy.
We are currently looking for dedicated, driven, and enthusiastic individuals who thrive in an environment that welcomes change and are looking for an opportunity for diverse experience, advancement on a growing team.


Job Overview

Reporting to the Director, Claims, the Claims Specialist – Health & Dental supports Wawanesa’s success through providing subject matter expertise and best practice recommendations so that Wawanesa Life’s claim handling practices align to Wawanesa’s values and desired customer experience. 


Job Responsibilities

  • Provide healthcare and dental claims best practice expertise to Wawanesa Life, taking into consideration Wawanesa Life values, Group product designs, culture and target market
  • Evaluate claims handling practices and provide recommendations based on industry best practices, Health and Dental industry knowledge and trends to support the Product and Pricing Dept
  • Stay abreast of industry practices to ensure recommendations are reflective on ongoing changes in the industry
  • Review and provide commentary or recommendations on extended health and dental exception requests
  • Collaborate with Group Underwriting on experience assessments
  • Assess customer service benchmarking
  • Perform ongoing research and analysis for industry and competitive market trends to support process improvement.
  • Contribute towards the claim’s litigation process including reporting, file coordination, communication with legal or reinsurers, and may be called upon to participate in examinations for the legal process.
  • Perform other duties as assigned.


  • Post-secondary degree/diploma in a medical or business-related field, or an equivalent combination of education and experience is a requirement.
  • 3 (three) years’ experience assessing complex health and dental claims
  • Strong problem solving and decision making skills, with the ability to identify and review potential impacts
  • Excellent customer service skills including empathy and concern for our customers
  • Strong communication and negotiation skills, with the ability to communicate at the right level for the intended audience.
  • Strong computer skills and knowledge of the Microsoft Office suite is required, including the ability to use Excel for reporting and analysis of information.
  • Advanced knowledge and demonstrated ability in the application of insurance contracts and policy wordings is required.
  • Strong attention to detail with the ability to identify relevant information and potential impacts
  • Demonstrated adherence to strict confidentiality and privacy of information policies, while maintaining a calm and collaborative approach.
  • Ability to read/write/speak (bilingual) in French is an asset.


Wawanesa provides its employees with a respectful, challenging and rewarding environment where they can maximize their potential while contributing to the company’s goals. Our employees are provided with highly competitive compensation packages (salaries, generous vacation allowance, leave top up, goal achievement plan, premium free benefits and a pension plan).  Wawanesa provides a stable and rewarding environment for its employees in today’s challenging markets.

If you are interested in this exciting, challenging position with Wawanesa, apply today with your Resume.

Accommodations are available as needed for all applicants.