Medical Coordinator (Hybrid/Remote)- EN
- Sherbrooke, QC, Canada
Full-time
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Job details
- Job type
- Full-time
- Apply by
- Posting language
- English
- Posted
Original job description
Job Description
Are you a people person with a knack for providing excellent customer service? Are you interested in working in a multilingual and friendly environment that encourages personal and professional development? We would love to meet you! Global Excel Management works with Canadian, International Insurers and prestigious brands, provides services to individuals who have purchased a travel insurance policy and need assistance on their trip or to submit a claim.
The Case Management team guides travelers around the globe through high acuity medical emergencies. As part of the Case Management team, the Medical Coordinator is responsible for medical management of medium-risk claims. This includes the prompt review, analysis and development of a case plan based on the understanding of what a clients’ travel policy covers, ensuring that medical expenses are appropriate and necessary. The Medical Coordinator will also assist with claim triage by assessing the medical risk of new claims and closing claims that do not meet case management criteria.
What does your typical day look like?
If you require assistance or accommodation during our recruitment process, please notify Human Resources so that we can review and consider how we may be able to assist you based on your individual needs.
We offer you
Québec Candidates : Salary starting at 26.78$/hour.
Are you a people person with a knack for providing excellent customer service? Are you interested in working in a multilingual and friendly environment that encourages personal and professional development? We would love to meet you! Global Excel Management works with Canadian, International Insurers and prestigious brands, provides services to individuals who have purchased a travel insurance policy and need assistance on their trip or to submit a claim.
The Case Management team guides travelers around the globe through high acuity medical emergencies. As part of the Case Management team, the Medical Coordinator is responsible for medical management of medium-risk claims. This includes the prompt review, analysis and development of a case plan based on the understanding of what a clients’ travel policy covers, ensuring that medical expenses are appropriate and necessary. The Medical Coordinator will also assist with claim triage by assessing the medical risk of new claims and closing claims that do not meet case management criteria.
What does your typical day look like?
- Review, summarize and analyze client medical records, with a focus in outpatient claims and some inpatient claims as needed;
- Assess the appropriateness of proposed medical treatment with the support of GEM Medical Directors/Medical Advisors;
- Formulate a case direction and communicate this to the team;
- Analyze clinical information and communicate the impact on eligibility for coverage to internal and external stakeholders;
- Use case management software to accurately and concisely document all call details and actions taken/required;
- Work with GEM Triage team in assessment of medical risk of incoming claims;
- Responsibilities may be adjusted to support alternate functions as business needs change;
- Hybrid work model post completion of orientation;
- Able to work various shifts and days of the week as required, primarily day shift with rotating evenings and weekends as required.
- College Diploma/University Degree in Nursing or equivalency medical training;
- Current license in good standing with the respective provincial nursing governing body;
- At least one year of clinical experience in an acute care setting an asset;
- Handle/communicate and exchange sensitive and confidential information in a professional manner;
- Excellent written and verbal communication skills with proven ability to communicate medical terms/concepts to diverse groups, including medical professionals and the general public;
- Able to handle fluctuating work volumes in a fast paced, customer focused environment;
- Able to successfully work independently and in a team;
- Proven ability to prioritize work responsibilities to achieve best possible outcomes;
- Basic understanding of travel insurance, insurance terminology and case management is an asset;
- Strong computer skills (Microsoft System including word, excel, teams, outlook).
- Excellent communication skills in English. English will be used on a daily basis to communicate with business clients and insured members, the majority of whom are located outside of Quebec, to obtain missing information, follow up on files, and collaborate with colleagues and departments across our various offices, including Ontario, Miami, Mexico, and other locations.
- Additional language skills, particularly in French and/or Spanish, are considered an asset.
If you require assistance or accommodation during our recruitment process, please notify Human Resources so that we can review and consider how we may be able to assist you based on your individual needs.
We offer you
- Global Excel offers more than a position;
- We offer a competitive compensation package that includes a base salary, performance bonus and an extensive benefits package;
- A professional future with opportunities for development, growth, and advancement;
- RRSP Match program;
- Financial assistance to employees who wish to continue their education;
- Work/life balance, health and wellness initiatives including an excellent EAP program;
- Employee engagement programs that focus on fitness, food, and fun.
Québec Candidates : Salary starting at 26.78$/hour.
More about this job
Responsibilities
Review and analyze medical records, assess proposed treatment, determine case direction, and communicate coverage eligibility and medical risk to relevant stakeholders. Document case activity, support claim triage, and manage medium-risk travel insurance claims.
Requirements
A college diploma or university degree in nursing, or equivalent medical training, and a current license in good standing with the relevant provincial nursing governing body are required. The role calls for strong communication and computer skills, the ability to handle confidential information and changing workloads, and preferably at least one year of acute care experience.
Skills
- Medical Record Review
- Clinical Information Analysis
- Medical Risk Assessment
- Case Management
- Claim Triage
- Insurance Coverage Eligibility Analysis
- Medical Documentation
- Customer Service
- Written and Verbal Communication
- Confidential Information Handling
- Prioritization
- Independent and Teamwork
- Microsoft Word
- Microsoft Excel
- Microsoft Teams
Benefits
- Performance Bonus
- Extensive Benefits Package
- RRSP Match Program
- Education Financial Assistance
- Work-Life Balance Initiatives
- Health and Wellness Initiatives
- Employee Assistance Program
- Employee Engagement Programs
Visa sponsorship
Not detected in the job text
Categories
- Healthcare
- Finance & Accounting
- Customer Service & Support
Keywords
- Travel Insurance
- Medical Coordination
- Case Management
- Medical Claims
- Claim Triage
- Medical Records
- Outpatient Claims
- Inpatient Claims
- Medical Risk Assessment
- Clinical Information
- Treatment Appropriateness
- Coverage Eligibility
- Medical Directors
- Medical Advisors
- Case Management Software
- Acute Care
- Nursing License
- Confidential Information
- Microsoft Word
- Microsoft Excel
- Microsoft Teams
- Microsoft Outlook
- Customer Service
- English Communication
- French
- Spanish