Case Coordinator - Toronto, Canada - PlanIT Search
Description
Job Overview
The Case Coordinator will be the point of contact for members requiring both medical and non-medical assistance. You will help members find health care providers, book appointments, and make travel arrangements. You will be responsible for communicating the available benefits to members, clients, and service providers.
Responsibilities
- Handle medically complex cases up to $10,000
- Interpret policies to provide insurance benefits and eligibility to members and health providers globally.
- Analyze insurance policies and communicate with claims and underwriting departments to make corrections to any discrepancies and inconsistencies.
- Complete adjudication of medical services to ensure claims are processed correctly facilitating timely payment.
- Redirect patients to innetwork facilities and prenegotiate future claims providing cost containment for the client.
- Document all written and verbal communication to ensure appropriate action during any customer or client complaints.
- Update clients on progress of assistance provided to their members.
- Communicate relevant information to all key stakeholders in a timely manner (clients, medical facilities, patients, families, etc.) and triage cases as per departmental policy to achieve best solutions.
- Available to work rotational shifts: days, afternoons, weekends, evenings, and public holidays
Qualifications and Education Requirements
- High school diploma or equivalent
- Minimum 2 years of customer service experience
- At least 1 year of case management experience
- Bilingual in French is required
- Excellent verbal and written communication skills in English
- Previous experience with MS Office products such as Word and Excel
- Superior time management skills
- Resourcefulness
- Ability to work independently and within a team
- Analytical and decisionmaking skills
- Ability to work in a fastpaced and dynamic environment
- Insurance and policy knowledge/interpretation
- Understanding of medical terminology
Preferred Skills
- Bilingual: French
Additional Notes
- This position requires availability for rotational shifts: days, evenings, weekends, and holidays; occasional overtime is required.
Job Types:
Full-time, Permanent
Salary:
$55,000.00-$58,000.00 per year
Benefits:
- Casual dress
- Dental care
- Extended health care
- Paid time off
- RRSP match
- Vision care
Schedule:
- 8 hour shift
- Day shift
Supplemental pay types:
- Bonus pay
- Overtime pay
Ability to commute/relocate:
- Toronto, ON: reliably commute or plan to relocate before starting work (required)
Education:
- Bachelor's Degree (preferred)
Experience:
- Customer service: 2 years (required)
- Case management: 1 year (required)
Work Location:
One location
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