[Hiring] Group Benefits Claims Adjudicator @EIO Solutions

Role Description

We are seeking a Group Benefits Claims Adjudicator and Benefits Support Specialist to support our TPA operations. In this role, you will be the heartbeat of our health and dental claims processing including HCSA, Wellness and Cost-Plus, ensuring that member inquiries are resolved quickly and adjudications are handled with precision. Working closely with our insurance carriers and partners, you’ll help maintain our high standards of service in a fully remote, fast-paced environment.

• Executing daily claims adjudication and providing direct support to our members.
• Managing member inquiries and tickets using HubSpot Helpdesk.
• Following and refining internal SOPs to ensure seamless benefits administration.
• Coordinating with insurance carriers and TELUS claims partners to resolve routine processing issues.
• Collaborating with the EIO team on projects.

Qualifications

• Bilingualism: Fluency in French and English (written and verbal) is required.
• Experience: 1–3+ years in claims adjudication, benefits administration, or a TPA/insurance environment.
• Technical Savvy: Experience with TELUS Adjudicare is a very strong asset; comfort using HubSpot or similar ticketing systems is preferred.
• Knowledge Base: A solid understanding of Canadian extended health and dental plans (Life, AD&D, Health, Dental, HCSA).
• Detail Oriented: Ability to interpret plan designs and assist with the creation of complex benefit booklets and ASO/HSA plan structures.
• Self-Starter: Proven ability to work independently and stay organized in a fully remote setting.

Requirements

• Take immense pride in accuracy and delivering a "wow" experience for members.
• Are a problem-solver who enjoys digging into plan documents to find answers.
• Thrive in a hands-on environment where you manage your own desk and priorities.
• Communicate clearly and empathetically in both French and English.
• Want a remote role where you can grow your technical knowledge of Canadian benefits.

Benefits

• Fully Remote: Work from anywhere in Canada.
• Growth Potential: Gain deep technical expertise in a growing organization.
• Impact: Your work directly helps members navigate their health and wellness benefits.
• Modern Tools: Work with a tech-forward stack (HubSpot, TELUS, Slack) instead of legacy systems.