Medical Case Coordinator

Are you compassionate, detail oriented and efficient? Do you have experience in the medical insurance industry? Are you versatile, resourceful, able to interpret policy, handle stressful situations, navigate challenging scenarios, and are a strong communicator? Do you want to work for a solid company with a long track record of success? If you answered yes to all of these, then please read on

Based in Markham, ON, and reporting to the Crisis Care Manager, Medical Case Coordinatorwill be responsible for managing a variety of medical cases and hospitalizations while offering compassionate, efficient, and accurate support to clients, their families, and interacting with various levels of medical providers. The Medical Case Coordinator role requires flexibility and is expected to provide outstanding service to our clients in compliance with **guard.me** policies and procedures and adhering to necessary regulatory obligations.

**guard.me** International Insurance recognizes people as our most valuable asset. We look for individuals who like working with and helping people and who are interested in long-term career growth within an established, successful company. The work environment is fast-paced and high-energy. You'll have a chance to communicate with others, as everyone's input is valued. The culture is truly collaborative. You'll be working with an established award-winning team with an impressive track record.

If we still have your attention, please read through the responsibilities and qualifications and if you think you’re a good fit, we’d love to review your resume

**Responsibilities**:

- Learn, understand and maintain knowledge of **guard.me’s **policies and procedures
- Manage case files; liaise with multiple stakeholders including, but not limited to healthcare providers, underwriter, clients and sales rep(s) quickly, efficiently and accurately
- Ensure the overall management of a medical claim is in accordance with the terms & conditions of the insurance policy
- Coordinate coverage for treatment plans in a manner that mitigates health risks, and implement strategies to contain costs without compromising quality of care
- Ensure all client interactions are loaded into the ADMIN system quickly and efficiently, including hospitalization checklist data (if not already loaded), client or healthcare providers medical information and/or reports
- Provide accurate and timely activity data to Case Manager and Leadership Team to include: Daily, Weekly & Monthly Activity & Call reports
- Coordinate with insurer and assistance provider on medical evacuations and repatriations
- Liaise and assist with school administrators as required.
- Able to take initiative, prioritize and multitask with a developed sense of urgency
- Assist and support insureds and their families regarding hospitalizations including appropriate claim submission requirements per policy guidelines
- Manage medical expense claims and provide support to Claims Team related to claims entry and other tasks as required.
- Find and develop resources to improve effectiveness of the Case Manager team.
- Work with our Clinic Coordinator to improve and support our provider network.
- Ensure all standard operating procedures (SOP) are documented as per business requirements
- Actively participate in weekly case management discussions within the team and Leadership
- Communicate effectively, while ensuring privacy to peers, managers, clients and insureds
- Conduct yourself in a professional and businesslike manner at all times
- Flexibility and availability to respond to calls outside of regular business hours, including nights, weekends and holidays as required.
- Staying abreast of healthcare conditions and developments.
- Such other duties and responsibilities as **guard.me**shall reasonably require

**Qualifications**:

- Undergraduate degree in Business or Health Sciences; or combination of education and experience
- A minimum of five (5) years in Case Management/Claims role with experience in adjudication
- Clinical/health and/or medical insurance background and experience is considered a strong asset
- An excellent communicator (spoken & written) with the ability to be compassionate in difficult medical situations
- Highly organized, able to multitask and adhere to timelines without compromising quality
- Ability and willingness to travel within assigned territory and beyond is essential
- Flexibility and availability to respond to calls outside of regular business hours, including nights, weekends and holidays on rotation
- Must have a valid Driver’s License, clean abstract and a reliable vehicle for travel
- Ability to communicate in a second language is an asset
- Intermediate to Advanced knowledge of Microsoft Office (Outlook/Teams/Word/Excel), Adobe Reader, Internet Search Engines (Google Chrome, Mozilla, IE)

Disclaimer: Please note that this document is intended to provide an overview of job accountabilities and does not nec