Dental Claims Adjudicator Dental Claims Adjudicator

Found in: Jooble CA O C2 - 1 week ago

Ontario, Canada People Corporation Full time

Claims Adjudicator to join our BPA team in North York.
The Junior Claims Adjudicator provides timely and accurate adjudication and reimbursement of benefit claims submitted by members covered under the L.Local 183 Member’s Benefit Trust Fund. Claims Adjudicator will:
Responsible for analyzing and adjudicating paper or electronically submitted claims, according to contract provisions and maintaining a claims assessment quota of 140 claims per day, depending on the claim complexity.
Responsible for evaluating all claims within the 5-day service standard of the Company.
Correspond and communicate via telephone, written correspondence or face-to face with members, consultants, providers and other internal and external customers.
Verify data entry for accuracy and completeness.
Provide Claims Team Lead with dental claims that need further review to dental consultant.
Data entry of claims sent to dental consultant is added and confirmed on a spreadsheet.
Reports to Claims Supervisor, Team Lead and Operations Manager.
Receives work direction from Claims Supervisor and Claims Team Lead.
Deals directly with Benefit Plan participants/members, their dependents and beneficiaries by phone, fax, email, mail or in person.
Corresponds with insurance providers, consultants, and Union Representatives with regards to specific claims submitted.
Local 183 Trust administration team to provide superior customer service.
Claims Adjudicator with BPA, you will need :
Analytical skills to research review and assess claims.
Familiarity with contract wording, policy provisions and the Insurance Act
Intermediate computer skills in the use of related computer applications including
Microsoft Word, Excel, Outlook, AS400, CRM, TELUS and Adjudicate in order to enter and track program data, process claims and, prepare reports and correspondence.
S. and successful completion of these courses of study during tenure in the position.
Extended health care and dental benefits
A retirement savings plan with company contributions
At People Corporation we are committed to helping businesses succeed. We are a national provider of benefits, retirement, wealth, wellness, and human resource solutions. BPA is a division of People Corporation and has served members and beneficiaries in their local communities since 1958. BPA is dedicated to providing a superior benefits experience to our members, businesses, and trusts in the local communities in which they live and operate. 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 employeehas the opportunity toreach their potential.

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