Indigenous Claims Processor
2 weeks ago
**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 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
**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 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)
**Physical Demands/Working Conditions**:
- Office and Call Center environment
- No heavy lifting
- Intermittent walking within the Claims Department for Team support
- Comfortable work stations
**Benefits of Working with FCH**:
- Inclusive work environment
- Generous Group Benefits with Pension
- Generous PTO
- Team culture
**Job Types**: Full-time, Permanent
**Salary**: $38,000.00-$41,000.00 per year
**Benefits**:
- Casual dress
- Company pension
- Dental care
- Disability insurance
- Employee assistance program
- Extended health care
- Life insurance
- Paid time off
- Vision care
Schedule:
- Monday to Friday
Supplemental pay types:
- Overtime pay
Ability to commute/relocate:
- Toronto, ON: reliably commute or plan to relocate before starting work (required)
**Experience**:
- Indigenous Cultural Knowledge: 7 years (preferred)
Work Location: In person
-
Claims Processor
5 days ago
Toronto, Ontario, Canada The Cigna Group Full timeExpress Scripts Canada administers health benefits claims on behalf of Indigenous Services Canada. The role of Claims Processor 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. Claim Processors are responsible...
-
Claims Processor
3 weeks ago
Toronto, Ontario, Canada The Cigna Group Full timeExpress Scripts Canada administers health benefits claims on behalf of Indigenous Services Canada. The role of Claims Processor 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. Claim Processors are responsible...
-
Claims Processor
4 weeks ago
Toronto, Ontario, Canada The Cigna Group Full timeExpress Scripts Canada administers health benefits claims on behalf of Indigenous Services Canada. The role of Claims Processor 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. Claim Processors are responsible...
-
Claims Processor
4 weeks 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 Processor
5 days ago
Toronto, Ontario, Canada The Cigna Group Full timeDescription: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...
-
Claims Processor- Express Scripts Canada
2 weeks ago
Toronto, Canada The Cigna Group Full timeExpress Scripts Canada administers claim adjudication services on behalf of Indigenous Services Canada. This role entails adjudicating Non-Insured Health Benefit Claims for Indigenous peoples in Canada. The role of a Senior Claims Processor is to process health benefit claims. This includes registering, reviewing, validating, and adjudicating claims on a...
-
Claims Processor- Express Scripts Canada
3 weeks 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- Express Scripts Canada
3 weeks ago
Toronto, Ontario, Canada The Cigna Group Full timeThis is a 3 Month ContractDescription: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...
-
Claims Processor- Express Scripts Canada
1 month ago
Toronto, Ontario, Canada The Cigna Group Full timeThis is a 3 Month ContractDescription: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...
-
Claims Processor- Express Scripts Canada
1 month ago
Toronto, Canada The Cigna Group Full timeThis 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...
-
Claims Processor- Express Scripts Canada
3 weeks ago
Toronto, Canada The Cigna Group Full timeThis 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...
-
Claims Processor- Express Scripts Canada
1 month ago
Toronto, Canada The Cigna Group Full timeThis 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...
-
Claims Processor- Express Scripts Canada
3 weeks ago
Toronto, Canada The Cigna Group Full timeThis 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...
-
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
4 weeks ago
Toronto, Canada The Cigna Group Full timeExpress Scripts Canada administers health benefits claims on behalf of Indigenous Services Canada. The role of Claims Processor 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. Claim Processors are...
-
Claims Processor
3 weeks ago
Toronto, Canada The Cigna Group Full timeExpress Scripts Canada administers health benefits claims on behalf of Indigenous Services Canada. The role of Claims Processor 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. Claim Processors are...
-
Indigenous Claims Clerical Support Clerk
2 months ago
Toronto, Canada First Canadian Health Full timeOur partner and client, Express Scripts Canada, administers on behalf of Health Canada Dental Claim Adjudication. This role entails the completion of tasks to support adjudicating Non-Insured Health Benefit Dental Claims for Aboriginals in Canada. The role of a Clerical Support Clerk is to perform all administrative tasks required to ensure that the claims...
-
Medical Claims Processor
6 days ago
Toronto, Ontario, Canada Allstate Canada Full timeAllstate Insurance Company of Canada is a leading home and auto insurer focused on providing its customers prevention and protection products and services for every stage of life. The company is proud to have been named a Best Employer in Canada for nine consecutive years and prioritizes supporting employees and fostering an inclusive, welcoming corporate...
-
Medical Claims Processor
6 days ago
Toronto, Ontario, Canada Allstate Canada Full timeAllstate Insurance Company of Canada is a leading home and auto insurer focused on providing its customers prevention and protection products and services for every stage of life. The company is proud to have been named a Best Employer in Canada for nine consecutive years and prioritizes supporting employees and fostering an inclusive, welcoming corporate...
-
Insurance Claim Processor, Bilingual
6 days ago
Toronto, Ontario, Canada Clarity Hiring Full timeToronto ON6 months contrat Full time, Hybrid Our client is seeking a bilingual (French/English) claims specialist for their benefits management team.Responsibilities will include:Adjudicate assigned death benefit claims, including investigating claim details to determine validity, and communicating decisions verbally and in writing as required, and signing...
