- Responsible for analyzing and adjudicating claims according to contract provisions with the provider agreement.
- Responsible for evaluating all claims within the client service standard contracts of the Company.
- Correspond and communicate via telephone, written correspondence or face-to-face with benefit plan 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 daily, weekly, and monthly production benchmarks.
- Analytical skills to research, review and assess claims.
- Strong verbal and written communication skills.
- Strong attention to detail with exceptional organization skills.
- Ability to manage multiple cases simultaneously.
- Participation in Company sponsored insurance programs such as FLMI, ACS, ALHC and successful completion of these courses of study during tenure in the position.
- Intermediate computer skills in the use of related computer applications including Microsoft Word, Excel, and Outlook and our internal claims payment system in order to enter and track program data, process claims and prepare reports and correspondence.
- Cooperative team player with strong interpersonal skills.
- Exceptional customer service skills.
- Analytical skills to research, review and assess claims.
- Strong verbal and written communication skills.
- Strong attention to detail with exceptional organization skills.
- Ability to manage multiple cases simultaneously.
- Participation in Company sponsored insurance programs such as FLMI, ACS, ALHC and successful completion of these courses of study during tenure in the position.
- Intermediate computer skills in the use of related computer applications including Microsoft Word, Excel, and Outlook and our internal claims payment system in order to enter and track program data, process claims and prepare reports and correspondence.
- Cooperative team player with strong interpersonal skills.
- Exceptional customer service skills.
- Learn by working alongside our experts
- 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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Jr. Claims Adjudicator
1 day ago
People Corporation North York, CanadaWe are seeking a Jr. Claims Adjudicator to join our BPA team in North York. · The Junior Claims Adjudicator provides timely and accurate adjudication and reimbursement of benefit claims submitted by members covered under the L.I.U.N.A. Local 183 Member's Benefit Trust Fund. He or ...
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Junior Claims Adjudicator
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People Corporation Ontario, CanadaWe are seeking a Junior Claims Adjudicator to join our BPA team in North York. · The Junior Claims Adjudicator provides timely and accurate adjudication and reimbursement of benefit claims submitted by members covered under our clients' Benefit Trust Fund. He or she provides cou ...
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Junior Claims Adjudicator - Toronto, Canada - People Corporation
Description
Job Description
We are seeking a Junior Claims Adjudicator to join our BPA team in North York.
The Junior Claims Adjudicator provides timely and accurate adjudication and reimbursement of benefit claims submitted by members covered under our clients' Benefit Trust Fund. He or she provides courteous and professional customer service while maintaining departmental standards.
The Junior Claims Adjudicator will:
To be successful as a Junior Claims Adjudicator with BPA, you will need:
What's in it for you:
At People Corporation we are committed to helping businesses succeed. We are a national provider of benefits, retirement, wealth, wellness, and human resource solutions. Our experts and solutions serve over 20,000 clients representing nearly 3 million Canadians. We offer customized solutions designed to fit the unique needs of businesses and their employees, members and stakeholders.
About BPA:
BPA is a division of People Corporation and has served members and beneficiaries in their local communities since 1958. BPA is dedicated to providing a superior benefits experience to our members, businesses, and trusts in the local communities in which they live and operate.
Providing an inclusive, accessible environment, where all employees and clients feel valued, respected and supported is something we're committed to. We are dedicated to building a workforce that reflects the diversity of the communities in which we live, and to creating an environment where every employee has the opportunity to reach their potential.