Claims Examiner

2 months ago


Cambridge, Ontario, Canada Source Code Full time
Job Title: Claims Examiner

At Source Code, we are seeking a skilled Claims Examiner to join our team. As a Claims Examiner, you will play a critical role in reviewing, examining, and making decisions on a variety of claims in accordance with applicable policy and service standards.

Key Responsibilities:
  • Review and examine claims to ensure they are paid under the respective policy and within the contracted timeframes.
  • Conduct research to gather additional information needed to adjudicate claims.
  • Enter notes into the computer system as required.
  • Facilitate stop payment requests and process reissues accordingly.
  • Make outbound calls to customers or providers to obtain necessary information.
  • Create and send professional correspondence.
  • Respond to inter-departmental inquiries and escalations in a timely manner.
Qualifications:
  • Post-secondary education.
  • Minimum of 6-12 months experience as a Claims Examiner or similar role.
  • Ability to pay close attention to detail and multi-task.
  • Possess sound judgment and good decision-making skills.
  • Fluency in French is preferred.

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