Montréal, Québec, Canada
Onsite
Position Type:
PermanentIf you’re looking for a fulfilling career that can make a real difference in your life, and the lives of others, you’ve come to the right place.
As a national health solutions partner, we put people first in everything we do — and that begins with our team of 8,000+ professionals who bring a cross-section of diverse life experiences and career expertise to Medavie. By collaborating and innovating together, our employees are creating industry-leading solutions in insurance, primary care and emergency medical services that impact millions of lives in Canada each year.
Our mission is to improve the wellbeing of Canadians so that every life can be lived to the fullest — and it’s reflected in our award-winning culture. We celebrate individuality and value the diverse perspectives and skills our employees contribute. We go beyond providing competitive pay and comprehensive benefits to offer opportunities for personal and professional growth, flexible work options, meaningful experiences, and supportive leadership. Medavie is where employees can be their best selves, feel they belong, and achieve their full potential. Be part of it by applying for a position with us today.
Position Summary
The Appeals Specialist is responsible for conducting comprehensive and impartial reviews of appealed Life, Disability, and associated health-related insurance claim decisions. Acting as a senior subject matter expert, the Appeals Specialist evaluates medical, contractual, administrative, and occupational information to determine whether original claim decisions were appropriate and supported by policy provisions, evidence, and established claims practices.
This role serves as a key quality assurance function within the organization, ensuring consistency, fairness, and accuracy in claim adjudication. The Appeals Specialist provides expert guidance on complex claim matters, identifies opportunities for continuous improvement, and contributes to the enhancement of claims management practices through coaching, trend analysis, and stakeholder collaboration.
What You'll Do
Appeals Review and Decision Making
Contract and Policy Interpretation
Quality Assurance and Continuous Improvement
Consultation and Coaching
Stakeholder Communication
What You Need to Be Successful
We've got you covered!
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Pay Range: $82,648 to $91,831 CAD
The Base Pay range may vary depending on the successful candidate or other relevant job-related factors such as knowledge, skills, qualifications, experience and education/training. In addition to Base Pay, eligible Medavie employees may participate in various performance-based incentive programs. Payments under these programs are discretionary and subject to both individual and organizational results.
We believe our employees should reflect the communities we serve and welcome applications from candidates of all backgrounds. To provide the best experience possible, we will support you with accommodations or adjustments at any stage of the recruitment process. Simply inform our Recruitment team of your needs. We are committed to making sure recruitment, retention, advancement, and compensation are fair and accessible while following all relevant human rights and privacy laws. We appreciate everyone who has shown interest in this position. Only those selected for an interview will be contacted.
While Medavie may use automated tools, including AI, to support application screening, candidates are expected to complete all recruitment interactions independently—without AI assistance—to ensure a fair and equitable process.
If you experience any technical issues throughout the application process, please email: Medavie.Recruitment@medavie.ca.
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