Benefits Services Representative

OTIP (Ontario Teachers Insurance Plan)
Summary
Join the OTIP Group of Companies (OGC) and contribute to a supportive and inclusive work environment where employees feel valued. As a Benefits Services Representative, you will handle incoming calls, provide benefits information, resolve member concerns, and navigate our web and mobile app. You will assist members with online registration, educate them about OTIP's products and services, and resolve complaints. Collaboration with carriers to process claim adjustments and ensure timely resolutions is also a key responsibility. This role requires strong communication, problem-solving, and organizational skills. OTIP offers a rewarding salary, comprehensive benefits, and professional development opportunities.
Requirements
- A post-secondary school diploma
- A minimum of one year’s post-secondary training in insurance-related courses such as LOMA, HIAA or CEBS
- A minimum of one year’s experience in group health, dental and travel insurance
- A minimum of one year’s experience in a call centre environment
- Strong knowledge of group health, dental and travel insurance, as well as contracts and benefits
- The demonstrated ability to provide outstanding service in an accurate and efficient manner
- Exceptional communication skills and the demonstrated ability to deal effectively with all levels of internal and external stakeholders
- Superior time management and organizational skills to manage competing priorities
- Intermediate knowledge of Microsoft Office Suite applications
Responsibilities
- Assist members with online registration and navigation for our web portal and mobile app
- Educate members about OTIP’s products and services to ensure members’ needs are being fully met by OTIP
- Provides timely and accurate information in response to incoming telephone inquiries using an automated telephone system, computer applications, training material and other applicable resources
- Resolves member complaints regarding coverage, claims and service, and documents outcomes for future reference. This includes clarifying members’ complaints, investigating the problem, developing solutions, making recommendations to management, and following up to ensure resolution
- Works with the carrier to process claim adjustment requests and cheque stop-payments, and reissues requests related to claims adjudication issues, while ensuring decisions are made on a timely basis. Identifies trends in claim adjudication errors and problems
- Responds to member email inquiries from the department’s email queue within specified department turnaround times
- Provides information in response to inquiries from members and other departments regarding coverage, effective dates, and outstanding information, as requested
- Ensures a high level of customer satisfaction through effective support and excellent customer service, by providing quick and accurate service in a professional manor
- Drafts letters and prepares and processes responses to routine correspondence, while adhering to established standards
- Applies proper contractual provisions in accordance with related contracts and carrier requirements to determine member eligibility for requested benefits
- Issues member confirmation notices in response to member telephone inquiries and prints the necessary documents, as required
- Maintains historical records by filing documents and records of insurance transactions and maintaining master files, amendments, etc
- Maintains a comprehensive log and diary system and reviewing and flagging all problem situations for discussion with management, as required
- Keeps information confidential to protect operations
- Performs other duties within competence, as assigned
Preferred Qualifications
The ability to communicate in French is considered an asset
Benefits
- Rewarding salary and bonuses that truly value your dedication
- Industry-leading group benefits with 100% premium coverage (excluding LTD) that start on your first day
- Defined benefit pension plan for a financially confident retirement
- 100% coverage of approved continuing education and licensing fees (including RIBO courses in Ontario)
- Access to a wealth of learning resources, including LinkedIn Learning for professional development
- Flexible work-from-home and hybrid options
- Unlock your potential with opportunities for advancement