Claims Processor-3 Months Contact-express Scripts
4 months ago
**This is a 3 Month Contract**
**Description**:
Express Scripts Canada administers on behalf of Indigenous Services Canada Claim Adjudication. This role entails adjudicating Non-Insured Health Benefit Dental Claims for Indigenous people in Canada.
The role of a Claims Processor is to register, review, validate, and adjudicate claims on a daily basis ensuring data integrity in the system. Claims Processors are responsible for processing Pay Provider, Pay Client and Client Reimbursement claims for all regions and are responsible for ensuring all pended claims are processed within the standard turn-around time.
This role is instrumental in meeting our Claims Processing Service Levels which contributes to customer satisfaction and minimizes risk of financial penalties.
**Key Responsibilities**:
- Register, review, validate, and adjudicate claims on a daily basis as per processes documented in the APM.
- Monitor and handle pended claims to ensure they are settled according to the Service Level Standards.
- Prepare and send a Dental Provider Missing Information Return Form based on the requestor’s communication preference (mail or fax) and language preference for claims with missing or illegible data.
- Consistently meet the minimum accuracy standards of 98%.
- Consistently meet the productivity standards for assigned quotas within the established Service Delivery Standards.
- Participate in frequent quality and productivity touchpoints.
- Engage in bi-weekly claim department and monthly benefit process meetings.
- Handle claim adjustments that are provided from various departments.
- Participate in annual Privacy and Compliance Training.
**Qualifications**
- 1+ years’ experience with data entry with proven records of excellent accuracy
- Experience working in an operational setting an asset
- Experience in the group insurance industry an asset
- Excellent verbal and written communication skills.
- Strong focus on customer service is required
- Quick learner and ability to make decisions with mínimal supervision
- Strong analytical skills and ability to work or interpret data independently
- Self-motivation, determination and ability to work effectively in a fast paced, rapidly changing environment
- Excellent time management, organizational and interpersonal skills
- Working knowledge of Microsoft Office Suite of Tools (Word, Excel, Outlook)
**Express Scripts Canada is a Cigna company**
Express Scripts Canada is a subsidiary of Express Scripts, a Cigna company. Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, wellbeing and peace of mind of those we serve. Cigna offers an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioural health, pharmacy, vision, supplemental benefits, and other related products.
**About Express Scripts Canada**
Express Scripts Canada is a leading health benefits manager and has been recognized as one of the most innovative. Our clients include Canada's leading insurers, third party administrators and governments. We work with these clients to develop industry-leading solutions to deliver superior healthcare in a cost-controlled environment. We provide Active Pharmacy services to more than 7 million Canadian patients and adjudicate more than 100 million pharmacy, dental, and extended health claims annually. Through our proprietary consumer intelligence, clinical expertise, and patients-first approach, we promote better health decisions for plan members, while managing and reducing drug benefit costs for plan sponsors.
We offer a competitive salary and benefits package, along with a positive work environment built on solid corporate values, integrity, mutual respect, collaboration, passion, service and alignment.
We are an equal opportunity employer that promotes a diverse, inclusive and accessible workplace. By embracing diversity, we build a more effective organization that empowers our employees to be the best that they can be.
We are committed to creating a working environment that is barrier-free and we are prepared to provide accommodation for people with disabilities.
-
Claims Processor
3 months ago
Toronto, Canada The Cigna Group Full timeExpress Scripts Canada administers on behalf of Health Canada Dental Claim Adjudication. This role entails adjudicating Non-Insured Health Benefit Dental Claims for indigenous people in Canada.The role of a Claims Processor is to register, review, validate, and adjudicate claims on a daily basis. Claims Processors are responsible for processing Pay...
-
Claims Processor
3 months ago
Toronto, Canada The Cigna Group Full time**Description**: Express Scripts Canada administers on behalf of Indigenous Services Canada Claim Adjudication. This role entails adjudicating Non-Insured Health Benefit Dental Claims for Indigenous people in Canada. The role of a Claims Processor is to register, review, validate, and adjudicate claims on a daily basis ensuring data integrity in the system....
-
Claims Clerk
2 weeks ago
Toronto, Canada The Cigna Group Full timeReporting to the NIHB Claims Supervisor, the Clerical Clerk is responsible for performing day to day clerical duties with in the Clerical department. This includes opening, sorting mail, printing of faxes and scanning and filing of claim forms. Answering delivery door from couriers on a daily basis. Executing assigned daily tasks as priorities shift....
-
Claims Processor
1 week ago
Toronto, Ontario, Canada The Cigna Group Full timeAbout the RoleWe are seeking a highly skilled Claims Processor to join our team at The Cigna Group. As a Claims Processor, you will play a critical role in ensuring the timely and accurate processing of dental claims for indigenous people in Canada.Your primary responsibility will be to register, review, validate, and adjudicate claims on a daily basis,...
-
Claims Processor
1 week ago
Toronto, Ontario, Canada The Cigna Group Full timeAbout the RoleWe are seeking a highly skilled Claims Processor to join our team at The Cigna Group. As a Claims Processor, you will play a critical role in ensuring the timely and accurate processing of dental claims for indigenous people in Canada.Your primary responsibility will be to register, review, validate, and adjudicate claims on a daily basis,...
-
Claims Processor
3 days ago
Toronto, Ontario, Canada The Cigna Group Full timeAbout the RoleWe are seeking a highly skilled Claims Processor to join our team at The Cigna Group. As a Claims Processor, you will play a critical role in ensuring the timely and accurate processing of Non-Insured Health Benefit Dental Claims for indigenous people in Canada.Key ResponsibilitiesRegister, review, validate, and adjudicate claims on a daily...
-
Claims Processor
2 days ago
Toronto, Ontario, Canada The Cigna Group Full timeAbout the RoleWe are seeking a highly skilled Claims Processor to join our team at The Cigna Group. As a Claims Processor, you will play a critical role in ensuring the timely and accurate processing of Non-Insured Health Benefit Dental Claims for indigenous people in Canada.Key ResponsibilitiesRegister, review, validate, and adjudicate claims on a daily...
-
Claims Processor
4 days ago
Toronto, Ontario, Canada The Cigna Group Full timeAbout the RoleWe are seeking a highly skilled Claims Processor to join our team at The Cigna Group. As a Claims Processor, you will play a critical role in ensuring the smooth processing of Non-Insured Health Benefit Dental Claims for indigenous people in Canada.Key ResponsibilitiesRegister, review, validate, and adjudicate claims on a daily basis to meet...
-
Claims Processor
4 days ago
Toronto, Ontario, Canada The Cigna Group Full timeAbout the RoleWe are seeking a highly skilled Claims Processor to join our team at The Cigna Group. As a Claims Processor, you will play a critical role in ensuring the smooth processing of Non-Insured Health Benefit Dental Claims for indigenous people in Canada.Key ResponsibilitiesRegister, review, validate, and adjudicate claims on a daily basis to meet...
-
Claims Clerk
2 weeks ago
Toronto, Canada The Cigna Group Full timeReporting to the NIHB Claims Supervisor, the Clerical Clerk is responsible for performing day to day clerical duties with in the Clerical department. This includes opening, sorting mail, printing of faxes and scanning and filing of claim forms. Answering delivery door from couriers on a daily basis. Executing assigned daily tasks as priorities...
-
Claims Processor
1 day ago
Toronto, Ontario, Canada The Cigna Group Full timeAbout the RoleWe are seeking a highly skilled Claims Processor to join our team at The Cigna Group. As a Claims Processor, you will play a critical role in ensuring the timely and accurate processing of Non-Insured Health Benefit Dental Claims for indigenous people in Canada.Key ResponsibilitiesRegister, review, validate, and adjudicate claims on a daily...
-
Claims Processor
1 day ago
Toronto, Ontario, Canada The Cigna Group Full timeAbout the RoleWe are seeking a highly skilled Claims Processor to join our team at The Cigna Group. As a Claims Processor, you will play a critical role in ensuring the timely and accurate processing of Non-Insured Health Benefit Dental Claims for indigenous people in Canada.Key ResponsibilitiesRegister, review, validate, and adjudicate claims on a daily...
-
Claims Processor
2 weeks ago
Toronto, Ontario, Canada The Cigna Group Full timeAbout the RoleThe Cigna Group is seeking a highly skilled Claims Processor to join our team in a 3-month contract position. As a Claims Processor, you will play a critical role in ensuring the timely and accurate adjudication of Non-Insured Health Benefit Dental Claims for indigenous people in Canada.Key ResponsibilitiesRegister, review, validate, and...
-
Claims Processor
2 weeks ago
Toronto, Ontario, Canada The Cigna Group Full timeAbout the RoleThe Cigna Group is seeking a highly skilled Claims Processor to join our team in a 3-month contract position. As a Claims Processor, you will play a critical role in ensuring the timely and accurate adjudication of Non-Insured Health Benefit Dental Claims for indigenous people in Canada.Key ResponsibilitiesRegister, review, validate, and...
-
Claims Processor
2 weeks ago
Toronto, Ontario, Canada The Cigna Group Full timeAbout the RoleThe Cigna Group is seeking a highly skilled Claims Processor to join our team in a 3-month contract position. As a Claims Processor, you will play a critical role in ensuring the timely and accurate adjudication of dental claims for indigenous people in Canada.Key ResponsibilitiesRegister, review, validate, and adjudicate claims on a daily...
-
Claims Processor
2 weeks ago
Toronto, Ontario, Canada The Cigna Group Full timeAbout the RoleThe Cigna Group is seeking a highly skilled Claims Processor to join our team in a 3-month contract position. As a Claims Processor, you will play a critical role in ensuring the timely and accurate adjudication of dental claims for indigenous people in Canada.Key ResponsibilitiesRegister, review, validate, and adjudicate claims on a daily...
-
Indigenous Claims Processor
4 months ago
Toronto, Canada First Canadian Health Full time**Description**: Our partner and client, Express Scripts Canada, administers on behalf of Health Canada Claims Adjudication. This role entails adjudicating Non-Insured Health Benefit Dental Claims for Indigenous people in Canada. The role of a Claims Processor is to register, review, validate, and adjudicate claims on a daily basis ensuring data integrity...
-
Customer Service Representative
3 months ago
Toronto, Canada The Cigna Group Full timeThe Provider Call Centre is the main venue for communication between providers and Express Script Canada regarding day-to-day claims adjudication queries. The Customer Service Representatives reflect Express Script Canada’s commitment to accessibility and responsiveness to providers. This position is instrumental in meeting contractual objectives and...
-
Claims Clerk
7 days ago
Toronto, Ontario, Canada The Cigna Group Full timeReporting to the NIHB Claims Supervisor, the Clerical Clerk is responsible for performing day to day clerical duties with in the Clerical department. This includes opening, sorting mail, printing of faxes and scanning and filing of claim forms. Answering delivery door from couriers on a daily basis. Executing assigned daily tasks as priorities shift....
-
Customer Service Representative
4 days ago
Toronto, Ontario, Canada The Cigna Group Full timeAbout the RoleWe are seeking a highly skilled Customer Service Representative to join our team at Express Scripts Canada, a leading health benefits manager and a subsidiary of The Cigna Group. As a Customer Service Representative, you will play a critical role in delivering exceptional customer service to our healthcare provider clients.Key...
