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Health Claims Specialist
3 months ago
Position Overview
Department: Claims - Health & Dental Insurance Work Environment: Remote with occasional office presence for essential meetings Employment Type: Permanent, Full-Time
Are you meticulous and seeking a fulfilling role within the Insurance sector?
Primary Responsibilities:
- Assess and process health and dental claims, ensuring precision and compliance with contractual agreements.
- Authenticate and validate submitted documentation, confirming provider qualifications and enforcing necessary regulations.
- Exhibit proficiency in independently handling various claim categories while maintaining high productivity and quality benchmarks.
- Engage with members and providers to gather missing information, adhering to established turnaround times.
- Recognize opportunities for process enhancements and actively contribute to improvements.
- Gather essential information required for claim processing, evaluate reasonable costs, and make informed decisions to approve or deny claims based on contractual terms.
- Verify received documents, ensure provider acceptance, and apply appropriate controls (R&C, maximums, etc.) according to established authority levels.
Qualifications:
- College diploma (DCS) or equivalent experience
- 2-3 years of relevant industry experience
- Strong analytical abilities and sound judgment in decision-making processes.
- Ability to work autonomously and demonstrate availability
- Commitment to maintaining confidentiality of sensitive information
Preferred Qualifications:
- Two years of experience in processing health and dental claims
- Bilingual proficiency in French (both spoken and written)
Benefits Offered by iA Financial Group:
- Competitive compensation package, including an annual bonus for all permanent staff
- Emphasis on work-life balance, with additional Personal Leave Days beyond vacation
- Comprehensive Wellness program supporting physical activity and wellness expenses
- Medical and dental coverage for employees and their dependents, along with a Health Spending Account for uncovered expenses
- Defined Benefit Pension plan for retirement security
- Home office equipment program to optimize your work environment
- Participation in the Share Purchase Plan with matching contributions from iA
- Commitment to your professional development through an Education Assistance Program
