Healthcare Claims Processing Specialist

3 weeks ago

Ottawa, Ontario, Canada People Corporation Full time

Job Overview

We are looking for a Healthcare Claims Processing Specialist to support our operations at People Corporation.

The Claims Processing Specialist is responsible for managing health claims for group plan members by adhering to established guidelines and protocols. This role involves addressing inquiries received through various channels regarding claims, benefits, and general group plan policies, along with performing additional administrative tasks as required.

Key Responsibilities:

  • Providing timely and courteous responses to clients, members, and external contacts.
  • Drafting correspondence using standardized templates for members, carriers, or clients.
  • Delivering accurate and prompt information to members and clients about coverage, claims processing, and benefits.
  • Reporting any issues that arise during daily operations to management.
  • Collaborating with healthcare professionals.
  • Conducting data entry related to claims and member communications.
  • Verifying member eligibility, services, and claims parameters, including reviewing previous submissions and group contracts.
  • Ensuring accuracy and completeness of cheques, letters, forms, and reports.
  • Processing claims payments while applying relevant deductibles.
  • Interpreting and applying policies and administrative practices in claims adjudication.
  • Maintaining electronic records and documents, including scanning, filing, and data entry.
  • Verifying data for accuracy and completeness within the scope of the role.
  • Prioritizing tasks to ensure effective time management.
  • Updating procedure manuals and documenting new processes.

Qualifications:

  • Familiarity with medical terminology.
  • Knowledge of group or individual benefits administration.
  • Proficiency in Microsoft Office and standard office procedures.
  • Ability to learn and adapt to new software and technology.
  • Skill in extracting and interpreting information from technical sources.
  • Strong mathematical and organizational abilities, with effective time management skills.
  • Commitment to adhering to company policies and procedures.
  • Discretion in maintaining confidentiality of 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 and wellness programs.
  • Support for mental health for employees and their families.
  • Assistance in pursuing industry designations.
  • Competitive salary package.

At People Corporation, we are dedicated to providing businesses with effective solutions in benefits, retirement, wealth, wellness, and human resources. Our services cater to over 20,000 clients, representing nearly 3 million Canadians, with tailored solutions that meet the unique needs of businesses and their stakeholders.

About People Corporation:

We are committed to delivering 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 reach their full potential.

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