We are a leading financial services provider committed to making decisions easier and lives better for our customers and colleagues around the world. From our environmental initiatives to our community investments, we lead with values throughout our business. To help us stand out, we help you step up, because when colleagues are healthy, respected and meaningfully challenged, we all thrive. Discover how you can grow your career, make impact and drive real change with our Winning Team today.

Job Description

Reporting the Director, the successful candidate will be responsible for making sound and accurate decisions in consultation with Management, in the settlement and effective management of Affinity Markets Financial Intuitions Claims. This will follow the Company, Industry, and Legislated standards. To be successful in this role please keep in mind that it is not only what you do, but how you do it as well.

Role Accountability:

• Conduct structured claims adjudication training formally and informally as required (onshore and offshore, as well as Partner Areas) and tracing of EFT claims payment.

• Deliver and monitor the Teams’ Communication both verbal and written to ensure high quality of service, elevating issues or challenges once identified.

• Excellent independent problem-solving ability including research and presentation of potential solutions.

• Handle technical issues or requirements related to the claims such as check stop, pay, and reissue.

• Be a second line information resource for Partner Areas (Product, Customer Contact Center, Distribution, Policy Services) to provide the highest quality and service levels to customers (internal & external).

• Handle all Vendor invoice payments to ensure timely and accurate monthly payment.

• End to end Unclaimed Property handling for Health and Dental Claims ensuring the repository is updated timely and accurately.

• Adjudicate high dollar or complex claims including catastrophic claims up to benefit maximum.

• Process claims with 100% accuracy and generate Ad-hoc Reports for Underwriting, Contact Center, Product, In force Customer Service, and external customers (required for income tax purposes) ensuring data integrity and timeliness.

• Managing Drug Prior-authorization and Multisource Brand Requests accurately and timely and support Team as required

• Communicate and collaborate with partner areas (Product, Customer Contact Center, Distribution, Policy Services) to provide the highest quality and service levels to customers (internal & external).

• Act as first line information resource for Claims Adjudicator and oversight of the Teams Shared Inbox and Escalate issues as required

• Handle all daily requests from Manila office regarding suspended claims to help facilitate timely release of payments or rejection of claims if applicable (also backs-up Intermediate Claims Adjudicator)

• Effectively handle complex claims as needed (Ostomy, RWTO, large estimates, etc.) as needed and in support of Junior and Intermediate Claims Adjudicator.

Qualifications:

• Excellent knowledge of Affinity Health and Dental plans and systems

• Excellent knowledge of Referral Areas ((Product, Customer Contact Center, Distribution, Policy Services)

• Excellent knowledge of legacy insurance administrative systems (AWD, mainframe, ESC)

• Excellent knowledge of extended health benefits

• Excellent knowledge of medical/pharmacy terminology and medical supplies/ equipment.

• Excellent knowledge of EHC claim practices and complex claim issues such as specialized plans (Retired Women’s Teacher of Ontario), suspended claims

• Excellent analytical skills, ability to identify, research and resolve problems.

• Excellent knowledge of mainframe (Liberty Health System and Maximum Accumulation Screens) and MS Office (Excel and Word)

• Excellent knowledge of company plans and benefits including knowledge of insurance contract language and provincial integration (i.e.. ADP, SAIL, BC Pharma Care etc.)

• Excellent knowledge of Provincial Grant Processes

• Knowledge of Accounts Payable Processes and vendor relationships and processes (Broadridge)

Experience and Education:

• Post-secondary education or equivalent work experience

• Minimum 5-7 years claim experience or demonstrated performance at a senior level, will be an asset

Our commitment to you

Values-first culture- We lead with our Values every day and bring them to life together.

Boundless opportunity- We create opportunities to learn and grow at every stage of your career.

Continuous innovation- We invite you to help redefine the future of financial services.

Delivering the promise of Diversity, Equity and Inclusion- We foster an inclusive workplace where everyone thrives.

Championing Corporate Citizenship- We build a business that benefits all stakeholders and has a positive social and environmental impact.

About Manulife and John Hancock

Manulife Financial Corporation is a leading international financial services group that helps people make their decisions easier and lives better. With our global headquarters in Toronto, Canada, we operate as Manulife across our offices in Asia, Canada, and Europe, and primarily as John Hancock in the United States. We provide financial advice, insurance, and wealth and asset management solutions for individuals, groups and institutions. At the end of 2022, we had more than 40,000 employees, over 116,000 agents, and thousands of distribution partners, serving over 34 million customers. At the end of 2022, we had $1.3 trillion (US$1.0 trillion) in assets under management and administration, including total invested assets of $0.4 trillion (US $0.3 trillion), and segregated funds net assets of $0.3 trillion (US$0.3 trillion). We trade as ‘MFC’ on the Toronto, New York, and the Philippine stock exchanges, and under ‘945’ in Hong Kong.

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 recruitment@manulife.com .

The annual base salary for this role is listed below.

Salary range is expected to be between

If you are applying for this role outside of the primary location, please contact recruitment@manulife.com 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 also have the opportunity to participate in incentive programs and earn incentive compensation tied to business and individual performance.

Manulife offers eligible employees a wide array of customizable benefits, including health, dental, mental health, vision, short- and long-term disability, life and AD&D insurance coverage, adoption/surrogacy and wellness benefits, and employee/family assistance plans. We also offer eligible employees various retirement savings plans (including pension and a global share ownership plan with employer matching contributions) and financial education and counseling resources. Our generous paid time off program in Canada includes holidays, vacation, personal, and sick days, and we offer the full range of statutory leaves of absence. If you are applying for this role in the U.S., please contact recruitment@manulife.com for more information about U.S.-specific paid time off provisions.