- Register, review, validate, and adjudicate claims on a daily basis as per processes documented in the APM.
- Monitor and handle pended claims to ensure they are settled according to the Service Level Standards.
- Prepare and send a Dental Provider Missing Information Return Form based on the requestor's communication preference (mail or fax) and language preference for claims with missing or illegible data.
- Consistently meet the minimum accuracy standards of 98%.
- Consistently meet the productivity standards for assigned quotas within the established Service Delivery Standards.
- Participate in frequent quality and productivity touchpoints.
- Engage in bi-weekly claim department and monthly benefit process meetings.
- Handle claim adjustments that are provided from various departments.
- Participate in annual Privacy and Compliance Training.
- 1+ years' experience with data entry with proven records of excellent accuracy
- Experience working in an operational setting an asset
- Experience in the group insurance industry an asset
- Excellent verbal and written communication skills.
- Strong focus on customer service is required
- Quick learner and ability to make decisions with minimal supervision
- Strong analytical skills and ability to work or interpret data independently
- Self-motivation, determination and ability to work effectively in a fast paced, rapidly changing environment
- Excellent time management, organizational and interpersonal skills
- Working knowledge of Microsoft Office Suite of Tools (Word, Excel, Outlook)
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Senior Solutions Designer
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First Derivative Toronto, CanadaFirst Derivative is a global leader in consulting, business services and technology. We are the home for diverse thinkers and innovators. We know that our people are vital to our success and we are proud of the diverse and vibrant team we have built across the globe. With over 30 ...
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AKITU Inc Ontario, CanadaCompany Profile · AKITU Inc. is a fast-growing company providing Dental Practice Management Software for dental clinics in Canada. With a core focus on innovation and mastering the user experience our software, Akitu One, brings a unique perspective for dentists to streamline the ...
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Snowflake Developer
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Epsilon Solutions Ltd. Toronto, CanadaJob Title: Snowflake Developer · Term: Long Term Contract · Work Location: Toronto, Ontario, Canada · Job Description: · Design and implement Snowflake solutions based on project requirements. · Develop and optimize queries for data transformation and loading processes. · Impleme ...
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Test Analyst
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TV2 Consulting Toronto, CanadaJob Duties/Accountabilities: · Work onsite in Toronto, Canada up to 3 days a week collaborating with the team · Design and develop test automation scripts. · Use test automation guidelines · Research issues in software through testing · Collaborate with QA Analysts and Softwar ...
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Infotek Consulting Services Inc. Toronto, CanadaInfotek Consulting is searching for a seasoned Mongo DBA - this is a remote contract assignment based in Toronto · Description · Sr NoSQL/MONGO Database Analyst · About the Role · The candidate will be a member of a team within Data Management Services (DMS) called Alternative Da ...
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LinuxAdmin
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Azure DevOps Engineer
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ValueLabs Ontario, CanadaHello Job Seekers, · Please find the below Job Description Below · Role: Azure DevOps Engineer · Location: Charlotte, NC/ Salt Lake City, UT/Canada – Remote · Position: Full Time Employee (FTE) · Job Description: · 8+ years of experience in a Platform Engineering, Software Engine ...
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Java Developer with Python knowledge
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Cloud Systems Specialist Spécialiste Systèmes Cloud
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Senior Security Engineer
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Sr. Developer
Found in: Appcast CA C2 A - 1 day ago
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Claims Processor-3 Months Contact-Express Scripts Canada - Toronto, Canada - The Cigna Group
Description
The job profile for this position is Claims Associate Analyst, which is a Band 2 Senior Contributor Career Track Role.Excited to grow your career?
We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply
Our people make all the difference in our success.
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 Processor is to register, review, validate, and adjudicate claims on a daily basis ensuring data integrity in the system. Claims Processors are responsible for processing Pay Provider, Pay Client and Client Reimbursement claims for all regions and are responsible for ensuring all pended claims are processed within the standard turn-around time.
This role is instrumental in meeting our Claims Processing Service Levels which contributes to customer satisfaction and minimizes risk of financial penalties.
Key Responsibilities:
Qualifications
Note: Internal posting will close on January 17, 2024.
Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.
