- 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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Adjudicator, Disability Claims
1 week ago
People Corporation Toronto, CanadaWe are seeking an Adjudicator, Disability Claims to join our BPA team in Toronto. · As a disability claims adjudicator, you will make initial short term disability claim decisions based on eligibility requirements. You will work directly with clients by assessing their functional ...
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Jr. Dental Claims Adjudicator
1 week ago
People Corporation Toronto, CanadaWe are seeking a Jr. Dental Claims Adjudicator to join our BPA team in Toronto. · The Junior Dental 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 ...
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Student, Life Claims Adjudicator
1 week ago
Sun Life Toronto, CanadaOur student and new graduate programs offer a chance to explore Sun Life from the inside. You'll make a difference in the lives of our customers and communities, while building the skills and experience that allow you to grow in a meaningful and rewarding way. · The Individual In ...
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Intermediate Claims Adjudicator
2 days ago
People Corporation Vaughan, CanadaWe are seeking a Intermediate Claims Adjudicator to join our BPA team in North York. · The Intermediate 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 Tr ...
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Jr. Claims Adjudicator
1 week 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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Jr. Claims Adjudicator
1 week ago
People Corporation Ontario, 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 o ...
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Jr. Claims Adjudicator
5 days ago
People Corporation Toronto, CanadaJob Description · We 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 Benefi ...
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Junior Claims Adjudicator
3 days ago
People Corporation Toronto, CanadaJob 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 o ...
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Intermediate Claims Adjudicator
1 week ago
People Corporation Vaughan, CanadaJob Description · We are seeking a Intermediate Claims Adjudicator to join our BPA team in North York. · The Intermediate 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 ...
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Claims Processor- Express Scripts Canada
5 days ago
The Cigna Group Toronto, CanadaExpress Scripts Canada administers claim adjudication services on behalf of Indigenous Services Canada. This role entails adjudicating Non-Insured Health Benefit Claims for Indigenous peoples in Canada. · The role of a Senior Claims Processor is to process health benefit claims. ...
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The Cigna Group Toronto, Canada**This is a 3 Month Contract** · **Description**: · Express Scripts Canada administers on behalf of Indigenous Services Canada Claim Adjudication. This role entails adjudicating Non-Insured Health Benefit Dental Claims for Indigenous people in Canada. · The role of a Claims Proce ...
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Indigenous Claims Processor
2 days ago
First Canadian Health Toronto, Canada**Description**: · Our partner and client, Express Scripts Canada, administers on behalf of Health Canada Claims Adjudication. This role entails adjudicating Non-Insured Health Benefit Dental Claims for Indigenous people in Canada. · The role of a Claims Processor is to register, ...
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Consultant, Individual Disability Claims
3 days ago
Manulife Ontario, CanadaWe are a leading financial services provider committed to making decisions easier and lives better for our customers and colleagues around the world. From our environmental initiatives to our community investments, we lead with values throughout our business. To help us stand out ...
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Claims Examiner
1 week ago
Matrix Labour Leasing Ltd. Toronto, CanadaMatrix is hiring Claims Examiners for our client, a Financial Industry leader in Canada. As a part of the Claims Examiner team, you will have the opportunity to support the client's business by reviewing, investigating, and assessing group health and dental benefit claims submitt ...
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Claims Specialist
4 days ago
Munich Re Toronto, Canada**Claims Specialist (Group LTD)**: · The Claims Specialist reports to the AVP Claims and manages assigned claims and clients. The role valuates and proactively assists clients in enhancing their claim practices and performs client reviews and supports industry presentations / int ...
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Intermediate Accident Benefit Adjuster
4 days ago
Saskatchewan Government Insurance Toronto, CanadaDo you value integrity and innovation? How about passion and caring? Great Us too, and that's why you'll fit right in. Our intentional culture promotes trust and participation, encouraging you to bring your heart and mind to work every day. · Out-of-Scope · Business Unit/Location ...
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Indigenous Claims Clerical Support Clerk
1 week ago
First Canadian Health Toronto, Canada**JOB POSTING - Toronto** · **Position Title** Claims Clerical Support Clerk **Available**:Full-time · - Permanent · **Department**:Health Claims Administration **Reports To**:Manager, HCA · **Description**: · Our partner and client, Express Scripts Canada, administers on behalf ...
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Account Coordinator
4 days ago
People Corporation Toronto, CanadaWe are seeking an Account Coordinator to join Prosure Group in Toronto, ON. · Reporting to the Manager, Client Services the Account Coordinator is responsible for the adjudication and claims payment for all HSA and Cost Plus Clients. This individual will also be responsible for a ...
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Claims Expert
1 week ago
Swiss RE Toronto, Canada**About the Team**: · We are a highly skilled claims team located in various offices throughout Canada and the U.S. Our department works closely with colleagues in Client Markets, Underwriting, Products, Actuary and HR. We are proud to deliver unparalleled customer service to our ...
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The Cigna Group Toronto, CanadaCustomer Service Representative - Express Scripts Canada · The Provider Call Centre is the main venue for communication between providers and Express Script Canada regarding day-to-day claims adjudication queries. The Customer Service Representatives reflect Express Script Canada ...
Junior Claims Adjudicator - Ontario, Canada - People Corporation
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 employeehas the opportunity toreach their potential. If you require an accommodation or an alternative format of any posting please reach out to
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Junior Claims Adjudicator professionals in Toronto
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Sadaf Ishak Moheddin
Experienced Product Owner
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Inderjyot Singh
Health Informatics
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Trinity Ho
HR Student