- Review, examine and direct the processing of unusual or complex claim cases or claims in excess of $5,000.00
- Obtain staff Claims Analysis daily to provide to the Claims Manager and investigate any problems
- Provide guidance and direction on a daily basis to claims unit
- Perform job supervisory duties required to assure proper training, instruction and development of staff
- Quality Control of Staff claims
- Assign all incoming claims to ensure Examiners receive appropriate number and type of claims and to redistribute as required
- Investigate and research complex claim issues or new procedures in the medical/dental field
- Regularly review and update the Claims manual
- Define, test and approve all system requests and enhancements in conjunction with the Claims Manager
- Review and authorize department supply order.
- Correspond and communicate via telephone, written correspondence or face-to-face with members, providers, consultants or other internal or external customers
- Monitor claim costs
- Perform any other duties delegated by the Claims Manager
- A minimum of 2-4 years in a claims adjudication role in the health & dental space
- Strong knowledge of claims adjudication processes and procedures
- Superior verbal and written communication skills
- Exceptional attention to detail with strong organization skills
- The ability to manage multiple cases simultaneously
- To participate in company sponsored insurance programs such as FLMI, ACS, ALHC, C.E.B.S. 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, Outlook and Benefit Plan Administration System (SPAS) and AS400 in order to enter and track program data, process claims and, and correspondence
- To be a cooperative team player with strong interpersonal skills;
- Exceptional customer service skills
- Experience with Adjudicare or other claims adjudication platforms
- Previous experience in a team lead or supervisory position
- 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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Claims Supervisor - Mississauga, Canada - People Corporation
Description
Job Description
We are seeking a Claims Supervisor to join our BPA team in Mississauga.
Please note that this position is 100% in-office. Hours: 8:30am - 4:30pm Monday to Friday.
The Claims Supervisor assists with coordinating the activities for a of approximately 8-10 employees at BPA Mississauga location and provides support for all staff at our field offices who adjudicate multiple benefit lines.
The Claims Supervisor will:
To be successful as a Claims Supervisor with BPA, you will need:
All-star candidates will have:
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.
