Claims Process Specialist, Specialized Distribution
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Job Summary The MSD Claims Process Specialist is responsible for leading and optimizing the end-to-end claims process within Specialized Distribution, including claims, complaints, and return requests. This role combines hands-on operational execution with process ownership to ensure timely investigations, accurate credit processing, effective issue resolution, and compliance with client contractual obligations.
Operating with a high degree of autonomy, the incumbent also manages complex and escalated claims, monitors trends and performance, provides high-quality customer support, and delivers recommendations, analytics, and process improvements to strengthen decision-making and overall team effectiveness.
The role also represents the function on client calls as a subject matter expert, providing operational insight, clarifying process requirements, and supporting issue resolution. Specific Responsibilities Lead the end-to-end claims process, including intake, investigation, validation, resolution, credit processing, and closure.
Manage complex, high-value, and sensitive claims, serving as the primary escalation point and ensuring timely, accurate resolution. Exercises independent judgment in claims validation, resolution approach, and escalation decisions. Ensure compliance with internal SOPs, client contractual requirements, and applicable regulatory expectations.
Partner with cross-functional stakeholders, including Customer Care, Finance, Quality, Operations, and clients, to resolve issues efficiently and support strong service outcomes. Analyze claims, complaints, and return trends to identify root causes, improve turnaround time, and drive corrective and preventive actions.
Develop, maintain, and report key performance indicators, service levels, and operational metrics to support performance monitoring and decision-making. Prepare metrics, present results and action plans during client business reviews, and represent the claims function on client calls as a subject matter expert.
Maintain accurate manufacturer return policies and provide guidance to optimize returns-related processes and team execution. Support Order-to-Cash and product returns workflows by monitoring performance, identifying improvement opportunities, and strengthening outcome measurement.
Lead and support continuous improvement initiatives, including process standardization, documentation, system enhancements, and implementation of new tools, workflows, and pilots. Provide guidance and informal leadership to team members handling claims-related activities while fostering knowledge sharing and consistency of execution.
Maintain current knowledge of relevant product categories, industry trends, and business conditions, while acting as an ambassador of McKesson's corporate values. Qualifications Working Experience Experience in pharmaceutical environment (3PL distribution experience an asset).
Retail/Wholesale/Hospital supply chain and procurement management experience an asset. Experience managing client relationships in a service-based environment Experience with data analytics and database/systems management. Education University degree in relevant discipline.
Personal Development and Soft Skills Strong analytical and problem-solving skills. Strong attention to details Demonstrated leadership. Excellent partnering skills. Excellent communication and presentation skills. Ability to collaborate with various levels of management and employees.
Ability to multi-task, working proactively and independently in a fast-paced, dynamic environment. Technical Skills Bilingual, both written and spoken. Extensive knowledge of MS Office products (Power Point, Excel, Word, Project, Visio and PowerBI).
Knowledge of S&OP an asset. Other Skills and Capabilities Strong business and accounting acumen. Client-focused; solutions oriented. Ability to work as part of multi-functional teams. Regulatory awareness. Attention to detail, whilst maintaining a strong sense of summary and ability to synthesize.
Ability to identify operational and strategic issues and proactively drive solutions. Available for travel (less than 4 trips per year, with potential overnight stay). #LI-JT2 We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards.
This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered.
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