Claims Assessor- Bilingual

2 months ago

Thunder Bay, Canada Ministry of Health Full time

Do you have in interest in providing timely, accurate and cost effective delivery of claim services to health care providers and the public in support of the Ministry of Health 's health care delivery strategies? If so, bring your knowledge of medical terminology, human anatomy and your ability to authenticate, adjudicate and facilitate payment of claims for health care benefits to our team

**OPS Commitment to Diversity, Inclusion, Accessibility, and Anti-Racism**: We are committed to build a workforce that reflects the communities we serve and to promote a diverse, anti-racist, inclusive, accessible, merit-based, respectful and equitable workplace.

Visit the **OPS Anti-Racism Policy** and the **OPS Diversity and Inclusion Blueprint** pages to learn more about the OPS commitment to advance racial equity, accessibility, diversity, and inclusion in the public service.

We offer employment accommodation across the recruitment process and all aspects of employment consistent with the requirements of Ontario's **Human Rights Code**. Refer to the "How to apply" section if you require a disability-related accommodation.

**What can I expect to do in this role?**: You will:

- Use your research skills to assess claims and analyze payment irregularities within strict deadlines
- Respond to inquiries
- Initiate payments, adjustments or recoveries
- Provide service to medical providers and the public
- Deal with confidential and sensitive medical and personal information

**How do I qualify?**:
**Mandatory**:

- You must possess oral French language skills at the advanced level. Your proficiency level will be confirmed before hire.

**Knowledge**:

- Demonstrated knowledge of medical terminology and human anatomy to read and understand operative and emergency reports.

**Research and Analytical Skills**:

- Ability to evaluate and adjudicate stakeholder claims.
- Ability to determine appropriate payment.

**Organizational Skills**:

- Ability to organize and manage own workload, process a high volume of claims and inquiries within strict timeframes.

**Tact, Diplomacy and Communication Skills**:

- Demonstrated ability to provide detailed and understandable explanations (oral and written) on work processes and claims payments to internal and external clients.
- Demonstrated interpersonal skills to interact with clients and team members and to understand and respond appropriately to issues, dealing with conflict situations and/or with sensitive medical/financial information.
- Demonstrated experience working cooperatively in a team to meet deadlines and organization goals and assisting in the training of new and existing employees.

**Mathematical and Computer Skills**:

- Ability to calculate fees, recognize billing irregularities and reconcile payments and adjustments.

**Additional Information**:
**Address**:

- 1 Bilingual English/French Permanent, 435 James St S, Thunder Bay, North Region, Criminal Record Check

**Compensation Group**:

- Ontario Public Service Employees Union- Understanding the job ad - definitions
- **Schedule**:

- 3.7**Category**:

- Administrative and Support Services**Posted on**:

- Friday, March 22, 2024**Note**:

- This ad is also available in French.

Required security screening checks along with your written consent, will be sent to the Transition and Security Office (TSO), Corporate Talent Programs Branch, Talent and Leadership Division to evaluate the results. If applicable, the TSO, with your written consent, will request and obtain any additional employment screening checks that were not obtained directly by you.

A record under the Criminal Code and/or other federal offence record(s) does not automatically mean you will be ineligible for the position. The employment screening check(s) will only be reviewed and evaluated by the TSO for the purpose of making a security clearance decision. The details of an individual's employment screening check(s) will be considered in specific relation to the duties and responsibilities of the position being filled. Employment screening check records will be maintained by the TSO and kept strictly confidential.
- E-HL-212857/24

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