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Claims Administrator Specialist
1 week ago
**Company Overview:**
The AppleOne Employment Services team is seeking a highly skilled and bilingual Claims Administrator to provide exceptional support to our Claims Team.
This role requires strong time management and communication skills, as you will be handling phone calls, emails, and claims processing tasks with ease.
We value professionals who can prioritize tasks efficiently, maintain accurate records, and communicate effectively with internal stakeholders and external partners.
Salary:
$45-52K
Job Description:
As a Claims Administrator, your primary responsibilities will include:
- Managing inbound/outbound phone calls and documenting communications in the claims system.
- Responding to emails, triaging claims mail, and directing to appropriate folders or examiners.
- Escalating complaints, appeals, and legal correspondence as needed.
- Processing denied EOBs, accounts receivable inquiries, and EFT information for paid claims.
- Retrieving and managing claims documents from provider SFTP sites.
- Maintaining compliance with PIPEDA and HIPAA regulations.
- Entering invoices and open claims in the claims system.
- Providing excellent customer service and collaborating with teams daily.
Qualifications:
To succeed in this role, you should possess:
- A high school diploma or equivalent.
- At least 2 years of administrative experience, preferably in the travel insurance industry.
- Previous claims experience is a significant asset.
- Proficiency in MS Word and Excel.
- Strong communication, organizational, and problem-solving skills.
- Bilingual proficiency in French and English is preferred.
Preferred Skills:
If you have experience with:
- Travel, medical, dental, and vision claims.
- Medical coding, cost containment, GHIP recovery, and US medical claims.
We are currently looking for an active job opportunity and invite you to join our network of trusted professionals. By applying, you will ensure that our recruiters match you with suitable roles, taking the next step in your career journey.
