Third Party Insurer Administrator

1 month ago

Toronto, Canada hearinglife_Canada Full time

**About the Role**:
You will be a Subject Matter Expert on insurer policies and billing procedures and alongside the Clinic Support Team you will work on enhancing documentation, communication of best practices and assist clinics struggling with 3rd Party receivables. This role works closely with our Team Lead, Cash Applications, our Third Party Insurer and Payment Administrators.

**Responsibilities**:

- Resolve differences between funding received and expected funding.
- Provide support and assistance to clinics in collecting outstanding 3rd party funding.
- Follow up with clinics on outstanding client receivables and credit balances.
- Reconcile funding received to funding applied.
- Accept and process credit card payments from insurers as required.
- Prepare weekly deposit log of 3rd party funding received.
- Oversee and execute all 3rd party provider account creations, authorizer updates, and clinic updates including new users/providers, address changes, and operating name changes in timely manner. 3rd parties include all insurers across Canada such as but are not limited to: ADP, WSIB, VAC, WCB-BC, WCB-AB, WCB-MB, WCB-SK, FCH, AADL, and private insurers.
- Managing all 3rd party contracts for approvals, renewals, and closing accounts, in line with the Legal team, as needed.
- Creating and updating step-by-step documentation on 3rd party online billing procedures for clinic staff and coordinate training materials with Clinic Support team.
- Reporting on any updates/changes to 3rd party protocols, policies, and procedures to the team.
- Provide suggestions and improvements to existing HDIs/SOPs as they relate to 3rdparty processes, online billing, and claims.
- Liaise with various government 3rd party agencies to resolve provider setup issues.
- Work closely with team members to receive, validate, and when required, follow-up on 3rd party claims such as investigating and problem solving when remittances or payments are not being received (i.e. complete and submit indemnity forms for lost cheque payments).
- Proactively setting up EFT payments for all 3rd party payments, if possible.
- Maintain understanding of the company’s business system (Blueprint) to support staff on unpaid claims.
- Answering requests in a timely manner from clinic staff on provider creations, account updates/creations, online billing questions.
- Provide backup for colleagues in Clinic Support team and Third Party team, as needed, for clinic staff questions and requests.
- Ad hoc tasks as assigned

**Critical Skills Needed**:

- Intermediate to Advanced Skills with Microsoft Suites, Excel, Outlook and general computer use.
- Advanced knowledge of internal client management and PoS system.
- Excellent problem solving skills.
- Excellent organizational and communication skills.
- Team player who can also work independently with a can-do and positive attitude.
- Ability to multi-task and work well under pressure.
- Excellent attention to detail and thoroughness.

**Other Details**:

- ** This role is 100% on-site at HearingLife’s Corporate Office at 4950 Yonge Street, Suite 1600** however we currently function under a hybrid policy

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