Casse Resolution Specialist

Job summary

Investigate escalated complaints and claims disputes, determine root causes, document findings, and manage cases through timely resolution. Collaborate with internal teams and leadership, recommend process improvements, and support junior colleagues and claims operations.

Job details

At MSH, passion meets profession. We're a team of dedicated enthusiasts who find genuine fulfillment in what we do - and we're looking for someone who feels the same way. About the Role As a Case Resolution Specialist, you will play a key role in delivering exceptional service by investigating complex claims issues and resolving customer disputes. Acting as the primary point of contact for escalated cases, you will work closely with members, internal teams, and leadership to ensure concerns are addressed fairly, efficiently, and in line with company policies. This role combines strong analytical abilities with a customer-focused approach. Beyond resolving individual cases, you will identify trends, recommend process improvements, and help enhance the overall member experience. What You'll Do Investigate and Resolve Complaints Conduct thorough investigations into escalated complaints from members, call centers, and account management teams. Gather, review, and analyze information to determine the validity of disputes and identify root causes. Document findings accurately and maintain complaint records in accordance with established procedures. Manage cases from initial review through final resolution, ensuring timely follow-up and closure. Collaborate Across Teams Partner with Claims Adjudicators, Quality Assurance, Accounting, and Account Management teams to develop fair and effective resolutions. Review proposed corrective actions with Supervisors, Senior Team Members, and the Claims Manager before implementation. Ensure all stakeholders are informed through clear and proactive communication throughout the resolution process. Drive Continuous Improvement Identify recurring issues and service gaps that contribute to customer complaints. Recommend process improvements and corrective actions to enhance service quality and operational efficiency. Present recommendations and findings to Claims Management and senior leadership for approval. Support Team Success Provide guidance and support to junior team members on processes and best practices. Assist with claims processing and administrative activities during high-volume periods. Contribute to a collaborative team environment focused on delivering outstanding customer service. What You'll Bring Education College diploma or university degree. Experience 1-3 years of relevant professional experience, preferably within the insurance, healthcare, or medical assistance industries. Experience handling customer complaints, escalations, dispute resolution, or complex customer service situations. Technical Skills Proficiency with Microsoft Office applications. Ability to quickly learn and navigate multiple internal systems and tools. Preferred Qualifications Bilingualism Fluency in both English and French is a strong asset. Analytical Thinking Strong problem-solving skills with the ability to manage multiple priorities while maintaining attention to detail and accuracy. Communication Skills Excellent written and verbal communication skills. Ability to manage sensitive situations professionally, empathetically, and confidently. Teamwork & Adaptability Collaborative and proactive approach to work. Comfortable working in a fast-paced environment with shifting priorities. Why Join MSH International? At MSH International, you'll have the opportunity to make a real difference in the lives of travellers and clients worldwide. You'll join a collaborative, customer-focused team where your expertise, problem-solving skills, and commitment to service excellence will be valued and rewarded. What's In It for You Salary Range: 45-48k CAD annually + Variable Bonus (Final compensation will reflect the candidate's experience, skills, and qualifications) Flexible hybrid work setup Comprehensive health benefits Employee assistance program Wellness spending account RRSP matching Minimum 3 weeks vacation (plus generous sick and flex days) Tuition reimbursement Real opportunities for growth and skill development Inclusive, diverse workplace culture Leadership that genuinely cares about your success and well-being Clear paths for both vertical and horizontal career growth MSH is an equal opportunity employer committed to fostering an inclusive, barrier-free recruitment process. We welcome applications from all qualified individuals regardless of race, ancestry, colour, ethnic origin, citizenship, creed, sex, sexual orientation, gender identity or expression, age, record of offences, marital status, family status, or disability. If you require accommodation at any stage of the recruitment process, please reach out. We will work with you in accordance with the Ontario Human Rights Code and the Accessibility for Ontarians with Disabilities Act (AODA). We thank all applicants for their interest. Only those selected for an interview will be contacted. In accordance with Ontario's Working for Workers Four Act, 2024, MSH confirms that artificial intelligence tools may be used in the recruitment and selection process for this position

What you’ll do

Investigate escalated complaints and claims disputes, determine root causes, document findings, and manage cases through timely resolution. Collaborate with internal teams and leadership, recommend process improvements, and support junior colleagues and claims operations.

Requirements

Requires a college diploma or university degree and 1–3 years of relevant experience, preferably in insurance, healthcare, or medical assistance. Candidates should have experience handling complaints or escalations, strong analytical and communication skills, proficiency with Microsoft Office, and the ability to manage multiple priorities; English-French fluency is an asset.

Benefits

• Flexible Hybrid Work Setup
• Comprehensive Health Benefits
• Employee Assistance Program
• Wellness Spending Account
• RRSP Matching
• Minimum Three Weeks of Vacation
• Sick Days
• Flexible Days
• Tuition Reimbursement
• Growth and Skill Development Opportunities

Listed skills

• Customer service · Preferred
• written communication · Preferred
• Problem solving · Preferred
• Attention to detail · Preferred
• case management · Preferred
• Root Cause Analysis · Preferred
• Microsoft Office · Preferred
• Prioritization · Preferred
• Process Improvement · Preferred
• Cross-Functional Collaboration · Preferred

Other relevant skills

Identified from the job description. Confirm important requirements above.

• Complaint Investigation
• Dispute Resolution
• Claims Resolution
• Root Cause Analysis
• Customer Service
• Case Management
• Analytical Thinking
• Problem-Solving
• Written Communication
• Verbal Communication
• Microsoft Office
• Attention to Detail
• Prioritization
• Cross-Functional Collaboration
• Process Improvement
• Empathy

Job areas

• Customer Service & Support
• Healthcare
• Finance & Accounting
• Data & Analytics

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