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Customer Service Representative

1 month ago


Ottawa, Canada People Corporation Full time

We are seeking a Customer Service Representative - Claims to join our Coughlin team in Ottawa.
**The Customer Service Representative - Claims will**:

- Process paperless and traditional claims, and using the claims system to properly identify missing information on forms
- Perform data entry related to claims and member correspondence
- Convert specialist codes to comply with the fee guide
- Verify eligibility of members, drugs, services, providers, co-insurance, deductibles, payments, and procedure/dental codes, including reviewing previous submissions and group contracts/policies
- Verify cheques, letters, forms, addresses, and reports for accuracy and completion
- Investigate complaints, over and underpayments, and taking corrective action
- Respond to clients, members, or other external contacts in a prompt, efficient, and courteous manner at all times
- Prepare correspondence using company standard templates for members, carriers, or clients
- Provide accurate and timely information/assistance to members and clients concerning coverage, processing and paying claims, and benefits parameters
- Liaise with medical and dental professionals

**T**o be successful **as a** Customer Service Representative - Claims** with Coughlin & Associates, you will need**:

- **Bilingualism in English & French is required**:

- The ability to maintain good public relations, both within and outside the organization
- A demonstrated ability to provide excellent customer service in a fast-paced environment
- A good vocabulary of medical and dental terminology
- Sound knowledge in the concept of group or individual benefits administration
- Sound knowledge of Microsoft Office and standard office administration procedures
- The demonstrated ability to learn and master new software and technology
- Excellent grammatical, spelling, and communication skills in both official languages
- The ability to extract and interpret or simplify information from various technical sources
- Strong mathematical and organizational skills, the ability to prioritize and multi-task, and the ability to manage time effectively
- The ability to adhere to existing company policies and procedures
- The ability to use tact and discretion to maintain information in the strictest of confidence
- Training in industry related courses provided by CEBS (Certified Employee Benefits Specialists), LOMA (Life Office Management Association), or the ICA (International Claims Association)
- Experience processing electronic claims

**What's in it for you**:

- Learn by working alongside our experts
- Extended health care and dental benefits
- A retirement savings plan with company contributions
- A suite of Health & Wellness offerings
- Mental Health programs and support for you and your family
- Assistance for the completion of industry designations
- Competitive compensation

At People Corporation we are committed to helping businesses succeed. We are a national provider of benefits, retirement, wealth, wellness, and human resource solutions. Our experts and solutions serve over 20,000 clients representing nearly 3 million Canadians. We offer customized solutions designed to fit the unique needs of businesses and their employees, members and stakeholders.

About Coughlin & Associates Ltd.:
Across the country, thousands of Canadians rely on Coughlin & Associates Ltd. to design and administer their group medical, dental, disability, life insurance and pension benefits. Coughlin is a full-service benefits consultant and third party administrator. Our services include:

- Group benefits consulting and plan marketing
- Plan administration and correspondence
- Claims adjudication and payment

Established in 1958, Coughlin & Associates Ltd. provides services to some of Canada’s most respected companies, unions and public service organizations


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