Claims Adjudicator Position
3 weeks ago
Job Title: Claims Adjudicator
About the Role:
We are seeking a skilled Claims Adjudicator to join our team in Halifax. As a Claims Adjudicator, you will be responsible for analyzing and adjudicating claims according to contract provisions, maintaining departmental standards, and providing exceptional customer service.
Key Responsibilities:
- Analyze and adjudicate claims according to contract provisions.
- Maintain responsibility for evaluating all claims within the 5-day service standard.
- Correspond and communicate with members, consultants, providers, and other internal and external customers.
- Apply guidelines, determine coverage, complete eligibility verification, and identify discrepancies.
- Verify data entry for accuracy and completeness.
- Meet monthly production benchmarks, daily and weekly.
Requirements:
- 1-2 years experience adjudicating medical/dental/vision claims or accident benefits claims.
- Analytical skills to research, review, and assess claims.
- Strong verbal and written communication skills.
- Exceptional customer service skills.
- Strong attention to detail with exceptional organization skills.
- Ability to manage multiple cases simultaneously.
- Ability to learn complexities of multiple benefit plans.
- Intermediate computer skills in the use of related computer applications.
- To be a team player with strong interpersonal skills.
What We Offer:
- 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.
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