Investigator

Permanent Full Time 

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We are looking for an Investigator – Fraud Management (DPIS), Workplace Solutions) with a focus on dental benefits.

Are you a naturally curious problem solver? If so, we are seeking an investigator to join our high-performance team. Familiarity with dental claims or training within the dental industry would contribute to success in this role. This role would be a key member of a team that delivers robust and effective health and dental claims fraud prevention to Canada Life customers.

After completing an internal training program, the Investigator will apply their knowledge and experience to conduct dental investigations. While working closely with their leader, the Investigator will determine investigative next steps by assessing case information and claims details and then contact providers, clinics or plan members to validate services to ensure that claims are free from suspicion of fraud or abuse. Taking into consideration the evidence and other information gathered, the Investigator will propose and execute recommendations to resolve the case, proceed with recovery efforts or refer to special investigations.

To be successful in this role, you must possess superior written and verbal communication, problem solving and organization skills to ensure the accurate documentation of the investigation. 
 

This is a hybrid position – the successful applicants will be required to work 3 days a week in office with flexible working hours within our core business hours of 7am-5pm CST.
 

What you will do: 

• Conduct thorough case investigations of cases identified through various detection channels
• Understand and interpret data from various sources
• Develop and execute the investigative plan in a timely manner to obtain evidence where fraud or abuse is suspected by contacting (verbal and/or written) appropriate parties, including plan member, claimant and/or provider
• Work closely with other members of the team including investigators, data analysts and the Special Investigations unit
• Consult with Health and Dental subject matter experts, medical review board and/or consultants, regulatory bodies, Legal or other internal departments as warranted by the case 
• Accurately document investigative actions and outcomes according to department policy
• Where evidence supports an action, determine and execute the appropriate action according to established protocols
• Create comprehensive reports regarding investigative findings to support criminal, recovery, civil or labour relations actions as needed
• Communicate case information as necessary according to established protocols
• Identify fraud and abuse risks and make recommendations to mitigate future risk
• Collaborate on special projects as assigned including targeted investigations, department process innovations and system enhancements
• Participate in training and mentorship opportunities to other members of the team
• Keep current on industry trends and maintain appropriate professional development

What you will bring: 

• Dental clinic or dental industry experience would be an asset
• Claims knowledge would be considered an asset
• Completion of post-secondary level education (e.g. university or college degree/diploma)
• Minimum two years related work experience in an adjudicative, investigative, and/or analytical field
• A combination of relevant experience and education will be considered
• Strong decision making, problem solving and analytical skills
• Proven experience providing excellent customer service
• Excellent communication skills, both verbal and written, in fast-paced and unscripted situations
• Excellent organizational and time management skills; able to manage multiple, simultaneous investigations and re-prioritize as priorities change
• Understanding of Group Operations (including legacy systems)/Business knowledge would be an asset
• Demonstrated proficiency using Microsoft Applications such as Excel, Word and Outlook
• Ability to communicate in French is considered an asset
• Due to the high profile of a number of our clients, a Federal Government Enhanced Screening is a job requirement which will involve fingerprinting and a credit check. This is a personnel security status that is required before an employee can gain access to Protected B information, assets or work sites as outlined by the Government of Canada  website. The cost of submitting these checks will be covered by Canada Life.

Benefits:

• Opportunities to carry out challenging work in a dynamic, collaborative and fast-growing team
• ⁠Leaders who support your development in a friendly, supportive work environment
• A competitive and comprehensive rewards program including tuition reimbursement, bonuses and flexible benefits
• Paid vacation, personal days and employee volunteer day allotment
• The opportunity to participate in a variety of teambuilding activities and professional development activities that help to strengthen your skills and build strong relationships within the department and company
• Access to various sports leagues such as hockey and indoor soccer, an on-site fitness centre and cafeteria

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The base salary for this position is between  $39,200.00 minimum - $58,800.00 maximum annually.  This represents base salary only and does not represent other variable compensation components of our total compensation ( i.e. annual bonus, commission etc).  If you are selected to move forward in our recruitment process, your recruiter will be able to discuss additional details of our total rewards program with you.

Career opportunities will be open a minimum of 5 business days from the date of posting, closing dates will vary depending on the search activity. All applications received will be reviewed on a rolling basis.

Be your best at Canada Life- Apply today!

Being a part of Canada Life means you have a voice. This is a place where your unique background, perspectives and talents are valued, and shape our future success.

You can be your best here. You’re part of a diverse and inclusive workplace where your career and well-being are championed. You’ll have the opportunity to excel in your way, finding new and better ways to deliver exceptional customer and advisor experiences.

Together, as part of a great team, you’ll deliver on our shared purpose to improve the well-being of Canadians. It’s our driving force. Become part of a strong and successful company that’s trusted by millions of Canadians to do the right thing.

Canada Life serves the financial security needs of more than 13 million people across Canada, with additional operations in Europe and the United States. As members of the Power Financial Corporation group of companies, we’re one of Canada’s leading insurers with interests in life insurance, health insurance, investment and retirement savings. We offer a broad portfolio of financial and benefit plan solutions for individuals, families, businesses and organizations. 

We are committed to providing an inclusive, accessible environment, where all employees and customers feel valued, respected and supported. We are dedicated to building a workforce that reflects the diversity of the communities in which we live, and to creating an environment where every employee has the opportunity to reach their potential. 

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 Canada Life policies. To request a reasonable accommodation in the application process, contact talentacquisitioncanada@canadalife.com.

Canada Life would like to thank all applicants, however only those who qualify for an interview will be contacted.

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