Claims Processor
2 weeks ago
Express 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 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 contributes to Express-Scripts Canada by meeting our Claims Processing Service Levels which contributes to customer satisfaction and minimizes risk of financial penalties.
**This is a 3 month contract position**
**ESSENTIAL FUNCTIONS**:
- Registers, reviews, validates, and adjudicates claims on a daily basis as per processes to meet minimum accuracy Service Level Standards.
- Monitors and handles pended claims to ensure they are settled according to the Service Level Standards.
- Return Claims that are missing mandatory client/benefit information as per using either claim entry or the doc reg screen and entering reason for the return.
- Address envelopes and attach provider return letter to claim ; ensure all returns are sent out by the clerical department the same day
- Review and scan claim adjustment requests from the Call Center/Supervisor/Senior Processor/QA Analyst; ensure accurate adjustments are made and communicate completion details to the Call Centre for logging
**QUALIFICATIONS**:
- College degree or High school diploma/GED required
- Experience with data entry, excellent accuracy
- Experience working in an operational setting an asset
- Experience in the group health insurance industry an asset Strong focus on customer service is required
- Ability to work effectively in a fast paced, rapidly changing environment
- Excellent organizational and interpersonal skills
- Ability to work within a team
- Working knowledge of Microsoft Office Suite of Tools (Word, Excel, Outlook)
- Ability to work or interpret data independently
**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.
-
Bilingual Claims Processor
3 days ago
Toronto, Canada Cigna Full timeExpress 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...
-
Claims Processor
2 months ago
Toronto, Canada The Cigna Group Full timeExpress 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...
-
Claims Processor
3 hours ago
Toronto, Canada Cigna Full timeExpress 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...
-
Claims Processor-3 Months Contact-express Scripts
7 months ago
Toronto, Canada The Cigna Group Full time**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...
-
Claims Processor
6 days ago
Toronto, Canada MSH Americas - Diot-Siaci Group Full timeAbout the RoleWe are seeking an experienced Claims Examiner to join our team at MSH Americas - Diot-Siaci Group. This is an exciting opportunity for a motivated individual to work in a dynamic environment and make a positive impact on people's lives.Key Responsibilities:Process travel insurance claims for medical, trip cancellation/interruption, baggage,...
-
Claims Examiner
3 days ago
Toronto, Ontario, Canada MSH Americas - Diot-Siaci Group Full timeMedical Claims Processor Role at MSH AmericasWe are seeking a highly skilled Medical Claims Processor to join our team at MSH Americas. The ideal candidate will have experience handling claims and providing excellent customer service in a fast-paced environment.About the Role:This is a dynamic position that requires strong time management skills, claims...
-
Document Processor
4 weeks ago
Toronto, Canada Tarion Full time**Document Processor** **- DP1**20624** **Department**:Warranty Services, Customer Service **Type of Position**: Full Time, Contract (6 Months) **Location**: 7th Floor, 5160 Yonge Street, Toronto, ON **Reporting to**: Director, Customer Service **Work Model**:Hybrid - flexible work schedule _(All remote work must be completed _from your home office...
-
Dental Claims Specialist
4 days ago
Toronto, Ontario, Canada Express Scripts Inc. Full timeAbout the RoleWe are seeking a highly organized and detail-oriented Dental Claims Specialist to join our team on a contract basis. This role will be responsible for registering, reviewing, validating, and adjudicating claims on a daily basis.Key ResponsibilitiesRegister, review, validate, and adjudicate claims in accordance with established processes and...
-
Fraud Specialist Claims Processor
3 days ago
Toronto, ON, Canada Brown Consulting Group Full timeJoin CPA Professional Liability Plan Inc. and work alongside a dynamic team of skilled professionals in a specialized market. We are seeking a results-oriented Claims Specialist with the empathy, expertise, and determination to assist clients through the complexities of professional liability claims. In this role, you will manage a portfolio of...
-
Medical Claims Processor
3 days ago
Toronto, ON, Canada MSH Americas - Diot-Siaci Group Full timeYou are an experienced Claims Examiner who can handle a large case load, multi-task, and meet tight deadlines. You thrive in a fast-paced environment providing excellent customer service in both the claim turnaround and handling emails and incoming calls. You will have the desire to develop an in-depth understanding of this position and be able to easily...
-
Medical Claims Processor
7 months ago
Toronto, ON, Canada MSH Americas - Diot-Siaci Group Full timeYou are an experienced Claims Examiner who can handle a large case load, multi-task, and meet tight deadlines. You thrive in a fast-paced environment providing excellent customer service in both the claim turnaround and handling emails and incoming calls. You will have the desire to develop an in-depth understanding of this position and be able to easily...
-
Data Entry Claims Processor
7 months ago
Toronto, Canada Manion Wilkins & Associates Full time**WHO ARE WE?** We’re Manion, a Canadian firm that provides third party benefits administration, payments, and consulting services. Providing solutions to streamline the administration of an organization’s pensions and health benefits, they know how to deliver the highest value. Manion leads the way in web-based plan access and administration, making it...
-
Data Entry Claims Processor
7 months ago
Toronto, Canada Manion Wilkins & Associates Full time**WHO ARE WE?** We’re Manion, a Canadian firm that provides third party benefits administration, payments, and consulting services. Providing solutions to streamline the administration of an organization’s pensions and health benefits, they know how to deliver the highest value. Manion leads the way in web-based plan access and administration, making it...
-
Data Entry Claims Processor
7 months ago
Toronto, Canada Manion Wilkins & Associates Full time**WHO ARE WE?** We’re Manion, a Canadian firm that provides third party benefits administration, payments, and consulting services. Providing solutions to streamline the administration of an organization’s pensions and health benefits, they know how to deliver the highest value. Manion leads the way in web-based plan access and administration, making it...
-
Data Entry Claims Processor
6 days ago
Toronto, Canada Manion Wilkins & Associates Full time**WHO ARE WE?** We’re Manion, a Canadian firm that provides third party benefits administration, payments, and consulting services. Providing solutions to streamline the administration of an organization’s pensions and health benefits, they know how to deliver the highest value. Manion leads the way in web-based plan access and administration, making it...
-
Claims Clerk
4 months 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....
-
Data Entry Claims Processor
4 months ago
Toronto, Canada Manion Wilkins & Associates Full time**WHO ARE WE?** We’re Manion, a Canadian firm that provides third party benefits administration, payments, and consulting services. Providing solutions to streamline the administration of an organization’s pensions and health benefits, they know how to deliver the highest value. Manion leads the way in web-based plan access and administration, making it...
-
Data Entry Claims Processor
7 months ago
Toronto, Canada Manion Wilkins & Associates Full time**WHO ARE WE?** We’re Manion, a Canadian firm that provides third party benefits administration, payments, and consulting services. Providing solutions to streamline the administration of an organization’s pensions and health benefits, they know how to deliver the highest value. Manion leads the way in web-based plan access and administration, making it...
-
Travel Insurance Claims Processor
2 days ago
Toronto, Ontario, Canada MSH Americas - Diot-Siaci Group Full timeCompany Overview:">Msh Americas, a subsidiary of the Diot-Siaci Group, is a leading provider of travel insurance solutions. Our team is dedicated to delivering exceptional customer service and ensuring that our clients receive the best possible claims experience. Salary:">$62,000 - $82,000 per annum, depending on experience Job Description:">We are seeking...
-
Data Entry Claims Processor
7 months ago
Toronto, Canada Manion Wilkins & Associates Full time**WHO ARE WE?** We’re Manion, a Canadian firm that provides third party benefits administration, payments, and consulting services. Providing solutions to streamline the administration of an organization’s pensions and health benefits, they know how to deliver the highest value. Manion leads the way in web-based plan access and administration, making it...