Jr. Claims Administrator

2 days ago

North York, Canada One Team Health Full time

We are looking for a highly organized and proactive individual who thrives in a fast-paced environment and takes pride in delivering accurate, high-quality work.

This role offers an excellent opportunity for those looking to start their career in the insurance industry, gain hands-on administrative experience, and build a strong foundation in claims support, document management, and customer communication.

**PRIMARY DUTIES AND RESPONSIBILITIES**:

- Sort and scan incoming claims received by mail.
- Help track and manage claims in pending system queues.
- Prioritize claims based on company guidelines.
- Verify and confirm claim details for accuracy.
- Review claim documentation and ensure completeness.
- Open cases in the database system for non-managed claims.
- Gather any missing information required for processing.
- Utilize company systems to clarify claim details.
- Maintain and update claims tracker reports.
- Check benefits, source details, condition type, and reimbursement amounts.
- Assist with reviewing claim pricing details.
- Communicate with members and providers regarding claim inquiries.
- Add urgent notes into the system related to claims processing.
- Assist with entering coding for international claims as needed.
- Request provider additions when necessary.
- Perform other administrative tasks as required to support the claims team.

**REQUIREMENTS**:

- Prior administrative experience preferred; training will be provided.
- Strong attention to detail and ability to follow procedures.
- Ability to multitask and prioritize tasks effectively.
- Good analytical and problem-solving skills.
- Basic proficiency in Microsoft Office (Word, Excel, Outlook).
- Strong written and verbal communication skills.
- Ability to work independently and as part of a team.
- Willingness to learn and adapt to new processes.

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.

**Benefits**:

- Dental care
- Extended health care
- RRSP match
- Vision care

Schedule:

- Monday to Friday

Work Location: Hybrid remote in North York, ON M2J 4Y1

Application deadline: 2025-03-11

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