Medical Claims Specialist
7 days ago
Job Title: Medical Claims Clerk
We are seeking a highly skilled Medical Claims Clerk to join our team at People Corporation. As a Medical Claims Clerk, you will be responsible for processing group plan member health claims by applying established policies and procedures.
Key Responsibilities:
- Respond to clients, members, or other external contacts in a prompt, efficient, and courteous manner at all times.
- Prepare correspondence using company standard templates for members, carriers, or clients.
- Provide accurate and timely information/assistance to members and clients concerning coverage, processing and paying claims, and benefits parameters.
- Liaise with medical professionals to verify eligibility of members, drugs, services, providers, co-insurance, deductibles, payments, and procedure/dental codes.
- Verify cheques, letters, forms, addresses, and reports for accuracy and completion.
- Produce claims payments, including applying applicable deductibles.
- Interpret policies and administrative practices and correctly apply them in the adjudication of claims.
- Perform data entry related to claims and member correspondence.
Requirements:
- A 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.
- The demonstrated ability to learn and master new software and technology.
- Strong mathematical and organizational skills, the ability to prioritize and multi-task, and the ability to manage time effectively.
What We Offer:
- Competitive compensation.
- 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.
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