Medical Claims Adjuster
1 month ago
As Medical Claims Adjuster you will work primarily independently within a team environment. You will deliver an exceptional and consistent claims service experience through the fair and equitable adjustment of moderate to complex Medical Insurance claims via telephone and written correspondence. If you are a critical thinker, have the skills to interpret medical documents, and a passion to provide a positive customer experience this could be the right opportunity for you.
**Responsibilities**:
- Provide quality customer service
- Interpret medical records and policy wordings and determine policy coverage
- Investigate, evaluate and settle insurance claims
- Contact claimants, doctors and other insurance providers for additional information
- Adjust claims from inception to completion in a proactive manner
- Communicate and negotiate with claimants, providers, lawyers and insurers
- Finalize settlements and authorize payments
- Maintain accurate records
- Remain up-to-date industry knowledge
- Perform other duties as assigned
**Qualifications**
- College/University degree
- Minimum 2 to 3 years as a medical claims specialist/adjuster
- Experience reviewing medical reports
- Effective customer service skills including empathy and concern for the customers
- Strong communication skills, both written and oral
- Strong analytical skills
- Critical thinker
- Strong time management and organizational skills with the ability to prioritize work in a fast-paced, changing environment
- Detail oriented with a critical degree of accuracy regarding data entry
- Strong negotiation skills
- Data entry skills
Our office is located in Toronto (North York) just off of Hwy 401 and DVP, and is accessible by TTC transit. Free parking is also available for those who drive. Hours are full-time (40 hours/week), with assigned shifts available between 8:00AM and 7:00PM Monday through Friday, and weekends.
**Job Types**: Full-time, Permanent
**Benefits**:
- Company events
- Dental care
- Extended health care
- On-site parking
- Paid time off
- RRSP match
- Wellness program
Schedule:
- Holidays
- Monday to Friday
- Weekends as needed
Ability to commute/relocate:
- Toronto, ON: reliably commute or plan to relocate before starting work (preferred)
**Education**:
- Secondary School (preferred)
Work Location: In person
Expected start date: 2023-09-04
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