Health Services Facilitator

One Team Health is looking for a **Health Services Facilitator** to join our team. This entry-level role offers exciting growth opportunities and plays a key part in coordinating healthcare services and processing related claims in accordance with members’ insurance policies. The facilitator will ensure compliance with company protocols and objectives while delivering exceptional customer service to clients and healthcare providers.

We are seeking a highly organized and enthusiastic individual who thrives in a fast-paced environment and can consistently meet and exceed the day-to-day expectations of the Health Services team.

**PRIMARY DUTIES AND RESPONSIBILITIES**:

- Responsible to gather all necessary information to effectively open a new case and alert the Team Lead/Manager for timely assignment.
- Manage short-term non-medically complex cases to completion by providing benefit information, network details, and providing authorizations when required.
- Present cost-effective options for treatment by utilizing network facilities, collaborating with the Provider Relations team as applicable.
- Screen and complete non-medical requests such as benefit clarifications, extended length of stay information, updates on procedures, etc.
- Maintain all records of activity related to case management, financial expectations, and strategic plans as they relate to the case within the company database system.
- Provide excellent customer service to the insured members and offering guidance and support with each inquiry.
- Maintain comprehensive and accurate case notes along with other relevant data required to effectively process claims.
- Utilize problem solving skills and negotiating techniques to resolve conflicts.
- Communicate with Team Lead/ Manager as appropriate for problem solving, direction and planning, as well as knowledge issues.
- Initiate required forms, letters and/or policies to comply with organizational guidelines and initiatives.
- Adheres to all policies and procedures as outlined by One Team Health and client specific protocols.
- Perform all work in a PIPEDA and HIPAA compliant manner.
- Ensure strict standards for claimant/client confidentiality and complies with organizational and governmental regulations/policies.
- Assist with the claims processing
- Participation in statutory holiday coverage
- Other related duties as assigned.

**REQUIREMENTS**:

- Minimum 2 years experience in a customer service environment.
- Medical terminology knowledge
- Knowledge of insurance and/or claims processing an asset
- Proven excellent listening, verbal and written communication skills.
- Post-secondary education in a relevant field or equivalent work experience.
- Proficiency in the use of the internet.
- Familiarity and knowledge of Microsoft Suite.
- Familiarity with insurance products and/or terminology is an asset
- Familiarity with medical terminology is an asset

**SKILLS/ATTRIBUTES**:

- Enjoys interaction with clients/strong interpersonal skills.
- Maintain a positive attitude at all times especially when handling difficult situations.
- Presents a jovial and pleasant approach towards customers even under the most stressful situation.
- Show empathy for the customer’s situation.
- High level of customer service/Client focused.
- Strong listening, verbal and written communication skills.
- Possesses excellent organizational skills and able to set own priorities.
- Proactive/Takes initiative, able to work with mínimal supervision, especially during slow periods.
- Professional/High level of integrity.
- Logical and analytical thinker, excellent problem-solver and decision-maker.
- Team player/Flexible/Reliable.
- Successfully manage stress, especially during peak busy hours where many things can happen all at once.
- Be able to sit for long periods of time to ensure adequate coverage.

In Ontario, One Team Health, and affiliated organizations accommodate the needs of job applicants throughout its recruitment and selection processes in accordance with the Ontario Human Rights Code and the Accessibility for Ontarians with Disabilities Act. Accommodation needs must be provided in advance. To discuss your needs, please contact the individual noted in the posting.

**Job Types**: Full-time, Permanent

Additional pay:

- Bonus pay

**Benefits**:

- Dental care
- Extended health care
- RRSP match
- Vision care
- Work from home

Schedule:

- Day shift
- Monday to Friday

Application question(s):

- What is your expected salary range?

**Experience**:

- customer service: 2 years (preferred)
- insurance: 1 year (preferred)
- Medical terminology: 1 year (preferred)

Work Location: Hybrid remote in North York, ON

Application deadline: 2025-08-05