Jr. Claims Adjudicator

6 months ago

North York, Canada People Corporation Full time

We are seeking a Jr. Claims Adjudicator to join our BPA team in North York.

The Junior Claims Adjudicator provides timely and accurate adjudication and reimbursement of benefit claims submitted by members covered under the L.I.U.N.A. Local 183 Member’s Benefit Trust Fund. He or she provides courteous and professional
customer service while maintaining departmental standards.

**The Jr. Claims Adjudicator will**:

- Responsible for analyzing and adjudicating paper or electronically submitted claims, according to contract provisions and maintaining a claims assessment quota of 140 claims per day, depending on the claim complexity.
- Responsible for evaluating all claims within the 5-day service standard of the Company.
- Correspond and communicate via telephone, written correspondence or face-to face with members, consultants, providers and other internal and external customers.
- Verify data entry for accuracy and completeness.
- Provide Claims Team Lead with dental claims that need further review to dental consultant.
- Data entry of claims sent to dental consultant is added and confirmed on a spreadsheet.
- Maintain security and confidentiality of client records.
- Other duties as may be assigned from time to time by Management.
- Reports to Claims Supervisor, Team Lead and Operations Manager.
- Receives work direction from Claims Supervisor and Claims Team Lead.
- Corresponds with insurance providers, consultants, and Union Representatives with regards to specific claims submitted.
- Work cooperatively as a member of the L.I.U.N.A. Local 183 Trust administration team to provide superior customer service.

**To be successful as a Jr. Claims Adjudicator **with BPA, you will need**:

- Analytical skills to research review and assess claims.
- Familiarity with contract wording, policy provisions and the Insurance Act
- Compliant with government regulation pertaining to the Privacy Act (PPEIDA).
- Strong verbal and written communication skills.
- Strong attention to detail with exceptional organization skills.
- Ability to manage multiple cases simultaneously.
- Microsoft Word, Excel, Outlook, AS400, CRM, TELUS and Adjudicate in order to enter and track program data, process claims and, prepare reports and correspondence.
- Participation in company sponsored insurance programs such as FLMI, ACS,
- ALHC, C.E.B.S. and successful completion of these courses of study during tenure in the position.
- Cooperative team player with strong interpersonal skills.
- Exceptional customer service skills.

**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 BPA:
BPA is a division of People Corporation and has served members and beneficiaries in their local communities since 1958. BPA is dedicated to providing a superior benefits experience to our members, businesses, and trusts in the local communities in which they live and operate.

  • Junior Claims Adjudicator

    6 months ago

    North York, Canada People Corporation Full time

    We are seeking a Junior Claims Adjudicator to join our BPA team in North York. **The Junior Claims Adjudicator provides timely and accurate adjudication and reimbursement of benefit claims submitted by members covered under our clients’ Benefit Trust Fund. He or she provides courteous and professional customer service while maintaining departmental...

  • Claims Assessor

    4 days ago

    North York, Canada Ministry of Health Full time

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

  • Claims Representative I

    2 months ago

    North York, Canada belairdirect Full time

    Our employees are at the heart of what we do best: helping people, businesses and society prosper in good times and be resilient in bad times. When you join our team, you’re bringing this purpose to life alongside a passionate community of experts. Feel empowered to learn and grow while being valued for who you are - here, diversity is a strength. You...

  • Claims Administrator

    6 months ago

    North York, Canada TORONTO MEDICAL CENTRE Full time

    Our Busy Medical Clinic in North York has been in business for over 13 years. We are currently looking to hire a Claims Administrator for a full-time position. We are looking for an enthusiastic individual with extensive knowledge of MVA file management and SABS. **Responsibilities will include**: - maintain patient files and communicate with patients,...

  • Claims Coordinator

    6 months ago

    North York, Canada TORONTO MEDICAL CENTRE Full time

    Our Busy Medical Clinic in North York has been in business for over 13 years. We are currently looking to hire a Claims Administrator for a full-time position. We are looking for an enthusiastic individual with extensive knowledge of MVA file management and SABS. **Responsibilities will include**: - maintain patient files and communicate with patients,...

  • Dental Claims Consultant

    2 weeks ago

    North York (York Mills / Silver Hills), Canada Sun Life Financial Full time

    You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll...

  • Dental Claims Consultant

    2 weeks ago

    North York (York Mills / Silver Hills), Canada Sun Life Financial Full time

    You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll...

  • Dental Claims Specialist

    2 weeks ago

    North York (York Mills / Silver Hills), Canada Sun Life Financial Full time

    You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll...

  • Dental Claims Specialist

    2 weeks ago

    North York (York Mills / Silver Hills), Canada Sun Life Financial Full time

    You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll...

  • Medical Case Manager

    4 months ago

    North York, Canada One Team Health Full time

    One Team Health, a subsidiary of Argus Group Holdings Limited, is currently seeking a Medical Case Manager. This role will manage healthcare services for members from inception to completion of the claims process. Ensuring services are eligible, medically appropriate and in adherence with policy guidelines. Coordinating and communicating with our claimants,...

  • Human Resources Generalist

    6 months ago

    North York, Canada INKAS Armored Vehicle Manufacturing Full time

    As the HR Generalist at INKAS Group of Companies, you will be the sole department and company resource that works with the executive team and employees to ensure the development and implementation of effective and efficient human resource policies and procedures. As the HR Generalist you will be the go-to for company wide training and development,...

  • HR Generalist

    6 months ago

    North York, Canada INKAS Armored Vehicle Manufacturing Full time

    As the HR Generalist at INKAS Group of Companies, you will be the sole department and company resource that works with the executive team and employees to ensure the development and implementation of effective and efficient human resource policies and procedures. As the HR Generalist you will be the go-to for company wide training and development,...