Bilingual Disability Appeal Specialist

Location: Remote within Canada; listed locations include Montreal, Québec, New Brunswick, Nova Scotia, and Ontario

Salary: $82,648–$91,831 CAD per year

Company

hirify.global is a national health solutions partner providing insurance, primary care, and emergency medical services across Canada.

What you will do

• Conduct independent reviews of appealed Life, Disability, Critical Illness, AD&D, and related insurance claims.
• Analyze medical, contractual, financial, occupational, and administrative information to assess original claim decisions.
• Render decisions to uphold, modify, or overturn claim outcomes and prepare detailed rationales and correspondence.
• Interpret insurance contracts, policy provisions, legislative requirements, and internal guidelines while escalating legal, financial, reputational, and compliance risks.
• Identify quality and process improvements through audits, trend analysis, special projects, and continuous improvement initiatives.
• Provide subject-matter guidance, coaching, feedback, and decision support to claims teams and internal and external stakeholders.

Requirements

• Post-secondary education in business administration, health sciences, nursing, rehabilitation, insurance, law, or a related discipline.
• Minimum 5 years of progressive experience in Life and Disability claims adjudication, case management, appeals, or a related insurance role.
• Expertise interpreting group insurance contracts, policy provisions, and claims management practices.
• Experience assessing complex medical, contractual, financial, and occupational information.
• Strong understanding of Life, Disability, Critical Illness, and AD&D products and claims processes.
• English and French bilingualism is required for daily collaboration with teams and partners in Canada.

Nice to have

• Experience conducting quality assurance reviews, appeals, audits, or complex claim assessments.

Culture & Benefits

• Flexible work arrangements with an emphasis on work-life balance.
• Employer-paid health, vision, and dental coverage from the first day.
• 100% employer-matched defined contribution pension plan.
• Annual incentive bonus, paid vacation, and a vacation purchase program.
• Wellness benefits, health resources, fitness center discounts, and career growth opportunities.