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Claims Administrator
2 weeks ago
**Job Title**: Claims Administrator
**Language**: English
**Position Type**: Full time
**City**: Mississauga
**Work Type & Hours**: Permanent, Hourly Paid - 35-40 hours per week
**Work Environment**: Call Centre
**Career Level**: Professional & Experienced
**Application Deadline**:
**About Us**
**drias International LTD.**
driasi is a global-leading provider of business process outsourcing solutions. driasi’s team of insurance professionals are committed to delivering excellence in everything we do. With 40 years in operation, driasi is the premier choice for banks, insurance carriers, brokers, associations, and some of the largest and well-known corporations in North America.
driasi offers highly customizable contact centre, administration, and business process outsourcing services to exceed our partners’ needs.
At driasi, we invest in what we consider to be our most important asset - our employees. We assess, hire and train staff to meet both the brand and business objectives of our partners. Our employees are actively involved and connected to the client business and accounts they work on, allowing them to closely affiliate to the brands they represent.
driasi is searching for an energetic and self-motivated Bilingual Customer Service Representative to support call centre activities.
As a Bilingual Customer Service Representative, you will be a trusted advisor who will provide information and solutions to both employees and clients by telephone and in a face-to-face private setting. You will be compensated by a competitive compensation package including the following:
- Guaranteed base salary
- Comprehensive group and pension benefits package
- Paid time off
- Healthy meals and health club membership subsidy
- Continuing education reimbursement
**Summary Overview**:
The Claims Administrator supports team members through timely and efficient administration of claim processes. and as the first point of contact for our customers to guide them through the claims process. The claims administrator is guided by defined procedural constraints and works under the moderate supervision of the Team Leader and Senior Adjudicator.
**Essential Responsibilities** include the following. Other duties may be assigned:
- Ensures the timely set up of claims, including completing initial eligibility and contract review within established service standards.
- Prepares claims kits in a timely manner to be sent to claimants.
- Prepares certifications in a timely manner.
- Supports the division customer service delivery promise by establishing first contact with claimant and employer, providing information, setting context to manage expectations, and communicating ongoing claim status updates.
- Provides prompt and appropriate action in support of workflow for team within established service standards.
- Sets up and inputs new claims.
- Assigns claims to team members with consideration given to workload, workflow, and complexity criteria.
- Reviews and analyzes data to determine benefit eligibility and gathers policy/certificate provision information relating to the claim.
- Provides ongoing and timely communication with our customers based on department protocols; provides claim status updates, requests information and addresses general enquiries.
- Participates in team collaboration to ensure optimal workflow and adherence to client service levels.
- Coordinates workflow for team, utilizes caseload management reports and routes documentation/mail and enquiries to other teams as necessary.
- Inputs manual cheque requests using payment database.
- Responds to incoming enquiries from our customers, vendors, medical offices, etc.
- Prepares memos and correspondence as requested by team members.
**_ Qualifications:_**
**_ _**To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily. The qualifications, physical demands and work environment characteristics listed below are representative of the knowledge, skills and ability required to successfully perform the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
**_ Language and Communication Skills_**
**_ Computer Skills_**
A proficiency in Microsoft Office: Outlook, Word, PowerPoint, Excel, as well as fundamental computer navigation and typing skills required.
**Interested in applying?**
**Inclusion and Equal Opportunity Employment**
Please note all offers of employment at driasi are conditional upon satisfactory results of all pre-hire background checks.
We thank you for your interest in driasi. Only those selected for an interview will be contacted.
