Healthcare Claims Processor
4 weeks ago
Job Overview
We are looking for a Healthcare Claims Processor to become a vital part of our team at People Corporation.
The Claims Processor is responsible for managing group plan member health claims by adhering to established guidelines and protocols. This role involves addressing inquiries related to claims, benefits, and general group plan policies, while also performing various administrative tasks.
Key Responsibilities:
Responding to clients, members, or external contacts in a timely, efficient, and professional manner. Drafting correspondence using standardized templates for members, carriers, or clients. Delivering accurate and prompt information/assistance to members and clients regarding coverage, claims processing, and benefits. Notifying management of any issues encountered during daily operations. Collaborating with healthcare professionals. Performing data entry related to claims and member communications. Verifying member eligibility, services, and payment details, including reviewing prior submissions and group contracts. Ensuring accuracy in cheques, letters, forms, and reports. Processing claims payments while applying relevant deductibles. Interpreting policies and administrative practices accurately in the claims adjudication process. Maintaining electronic data and documents, including scanning, filing, and data entry. Verifying work and data for accuracy and completeness. Prioritizing tasks to ensure effective time management. Updating procedure manuals and documenting new processes.Qualifications:
Proficient understanding of medical terminology. Solid knowledge of group or individual benefits administration. Familiarity with Microsoft Office and standard office procedures. Ability to learn and adapt to new software and technology. Skill in extracting and simplifying information from technical sources. Strong mathematical and organizational abilities, with effective time management skills. Commitment to adhering to company policies and procedures. Capacity to maintain confidentiality with sensitive information.Preferred Skills:
Excellent written and verbal communication skills in both English and French. Ability to foster positive public relations within and outside the organization.Benefits:
Opportunity to learn from industry experts. Comprehensive health and dental benefits. Retirement savings plan with employer contributions. Access to Health & Wellness programs. Support for mental health for you and your family. Assistance with completing industry designations. Competitive salary package.At People Corporation, we are dedicated to empowering businesses. As a national provider of benefits, retirement, wealth, wellness, and human resource solutions, we serve over 20,000 clients and nearly 3 million Canadians. Our tailored solutions meet the unique needs of businesses and their employees.
About People Corporation:
We are committed to providing inclusive and accessible environments where all employees and clients feel valued and supported. Our goal is to build a diverse workforce that reflects the communities we serve, ensuring every employee has the opportunity to thrive.
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