Claims Examiner (6 month contract)
- Cambridge, ON, Canada
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Job details
- Posting language
- English
Original job description
Claims Examiner/Adjuster
Cambridge, ON (On-site)
6-month contract
Review, examine, calculate and make decisions on a variety of claims in accordance with applicable policy and service standards. Required to attain performance objectives on a monthly basis.
- Reviewing, examining, calculating, and making decisions on a variety of claims received in the claims processing unit, to ensure the claim is paid under the respective policy and within the contracted timeframes.
- Conducting research via policies/flipcharts that can provide additional information needed to adjudicate claims.
- Entering notes into the computer system/databases as required.
- Facilitating stop payment requests and processing reissues accordingly.
- Placing outbound calls to customers or providers to obtain information required to adjudicate a claim.
- Creating and sending various types of professional correspondence.
- Responding to inter-departmental inquiries.
- Responding to escalations in a timely manner.
Qualifications:
- Post-secondary education
- Minimum of 6-12 months experience as a Claims Examiner or similar role.
- Ability to pay close attention to detail and multi-task.
- Possess sound judgment and good decision-making skills.
- Fluency in French is preferred.
More about this job
Responsibilities
The Claims Examiner at Source Code will review, calculate and decide claims so they are paid under the policy and on time. The role also researches policies, updates systems, calls customers or providers, and writes correspondence.
Requirements
Candidates need post-secondary education and 6 to 12 months of claims examining or similar experience. They should be detail-oriented, able to multi-task, and show sound judgment. French fluency is preferred.
Skills
- Claims adjudication
- Policy interpretation
- Claims processing
- Claims calculation
- Decision-making
- Attention to detail
- Multi-tasking
- Outbound calling
- Professional correspondence writing
- Database data entry
- Stop payment processing
- Escalation handling
- Research
- French fluency (preferred)
Categories
- Finance & Accounting
- Insurance
- Customer Service & Support
Keywords
- Claims Examiner
- Claims Adjuster
- claims adjudication
- claims processing
- insurance claims
- claims examining
- policy review
- claims decisions
- stop payments
- reissues
- customer correspondence
- escalations
- Cambridge Ontario
- contract
- claims clerk
- bilingual French
Seniority
Entry level
Tools
- computer system
- databases
Languages
- English