WHO WE ARE

We’re a National Third-Party Administrator/Payor (TPA/TPP), with offices located in Kelowna BC & The Waterloo Region. Simply Benefits is improving the health benefits experience for employers, insurers and, well, everybody! Our team leverages digital-focused strategies to provide members with fast, easy and thoughtful benefits experiences. To put it simply, we provide group benefits plans, but we’re a technology company first. Our team embraces autonomy, complexity and a connection between effort and reward as three qualities that foster a truly satisfying career and strive to separate ourselves from the corporate herd.

Reporting to the Group Administration & Customer Service Manager, key responsibilities include but are not limited to:

• Processing enrollments, employee changes and terminations
• Ability analyze and investigate premium discrepancies.
• Processing of disability, Life, Critical illness and Out-of-Country claims
• Interpret related Benefit policies and procedures and support compliance with government and provincial regulations.
• Taking ownership and resolving client issues and concerns to the satisfaction of the client and business unit, including but not limited to interacting with customers (French / English) in a customer service capacity.
• Ability to navigate the system to efficiently answer questions (French / English) around coverage, members profiles, and where needed escalate issues to the corresponding team.
• Answer phone calls and assist members with claim/coverage inquiries when needed.
• Referring questionable/contentious claims for evaluation as needed and providing recommendations for action to help minimize fraud.
• Maintaining and updating all applicable system records.
• Contribute to the continuous improvement of business processes.