Claims Assessor

Job Description

Are you someone who enjoys assisting others and providing exceptional customer service? Do you thrive in a diverse and welcoming atmosphere that promotes personal and professional growth? Then, we are excited to connect with you

As a Claims Assessor, your main responsibility involves examining and enforcing claim benefits and limitations based on a thorough understanding of policy terms. You will be in charge of verifying claims for payment eligibility, reviewing them for customer service standards, and possibly engaging directly with clients. Additionally, you will play a critical role in cost containment by validating service bills, ensuring their authenticity, and confirming reasonable charges.

What does a typical day look like?

• Review policy terms to confirm claim coverage;
• Assess all written and verbal communications associated with the claim;
• Examine service bills, codes, and charges;
• Evaluate medical information for additional requirements or specialist reviews;
• Determine necessary claim documents as per policy terms;
• Request any missing claim components;
• Establish follow-up procedures;
• Communicate claim decisions and denials via phone, letter, or email;
• Verify and adjust claim entries if needed.

What skills and training are required?

• A university degree or college diploma is preferred;
• Experience with insurance benefits is an advantage;
• Understanding of healthcare systems and billing practices is beneficial;
• Proficient in Microsoft Office;
• Strong verbal and written communication skills in English, French proficiency is a plus;
• Exceptional organizational skills with a keen eye for detail and solid decision-making abilities;
• Ability to adapt to changing environments and high workloads in a fast-paced customer-centric setting.

We provide:

• Global Excel offers more than just a job;
• We ensure a promising career with competitive compensation, including base salary, bonuses, and benefits;
• Contact your local HR department for more information on available benefits at your workplace.

Keen to learn more about our company and life at Global Excel? Visit our Facebook, Instagram, LinkedIn pages, and website.

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