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Medical Claims Specialist
2 months ago
Job Summary
We are seeking a highly skilled Medical Claims Specialist to join our team at People Corporation. As a Medical Claims Specialist, you will play a critical role in processing group plan member health claims, responding to inquiries, and performing administrative duties.
Key Responsibilities
- Process group plan member health claims by applying established policies and procedures.
- Respond to written, electronic, or in-person inquiries related to claims, benefits payable, and general group plan policies.
- Perform other related administrative duties, including data entry, verification of eligibility, and claims payments.
- Liaise with medical professionals to ensure accurate and timely information.
- Verify accuracy and completeness of documents, including cheques, letters, forms, and reports.
- Interpret policies and administrative practices to apply them correctly in the adjudication of claims.
- Maintain electronic data and document systems, including scanning, faxing, filing, and data entry.
- Verify work and data for accuracy and completion.
- Prioritize work to ensure effective time management.
- Maintain procedure manuals and document new procedures.
Requirements
- Good vocabulary of medical terminology.
- Sound knowledge in the concept of group or individual benefits administration.
- Sound knowledge of Microsoft Office and standard office administration procedures.
- Demonstrated ability to learn and master new software and technology.
- Ability to extract and interpret or simplify information from various technical sources.
- Strong mathematical and organizational skills, ability to prioritize and multi-task, and ability to manage time effectively.
- Ability to adhere to existing company policies and procedures.
- Ability to use tact and discretion to maintain information in the strictest of confidence.
Preferred Qualifications
- Excellent grammatical, spelling, and communication skills in both official languages (English & French).
- Ability to maintain good public relations, both within and outside the organization.
What We Offer
- Opportunity to learn by working alongside our experts.
- Extended health care and dental benefits.
- A retirement savings plan with company contributions.
- A suite of Health & Wellness offerings.
- Mental Health programs and support for you and your family.
- Assistance for the completion of industry designations.
- Competitive compensation.
