Claims Administrator - Insurance Temporary to Full TimeHybrid Toronto - In office 2 days a weekend Insurance industry is an asset , Heath care industry Job OverviewThe Claims Administrator role will be responsible for providing administrative support to the Claims Team. The role involves handling inbound and outbound phone calls. Responding to variety of emails from provide and plan members. This role requires strong time management skills and very strong spoken and written language skills. Bilingual English/French is preferred.Responsibilities• Handle incoming phone calls from members and providers regarding claims status and accurately documenting all communication on the claim system• Handle email inbox, mail, replying to email or move new claims to Data Entry folders• Triaging all incoming claims mail received, and add to claims and/or redirect to the examiners when necessary• Escalate complaints, appeals, and legal correspondane as appropriate• Filter denied EOBs and place in relevant folder to be mailed out• Handle all inquires regarding accounts recievable from providers• Upload EFT information to the Accounting team for paid claims• Retrieve claims documents from sFTP sites used by some providers• Ensure all work complies with PIPEDA and HIPAA• Provide excellent customer service for claims matters both in person and via written correspondence• Work closely with the Claims team and other teams as required on a day-today basis• Open claims and enter invoices into the claims systemQualifications and Education Requirements• High school diploma or equivalent• Experience in the travel insurance industry is required• Minimum 2-3 years previous administration experience• High level of proficiency in MS Office Suite, specifically Word and Excel• Superior verbal and written communication skills• Strong time management and organizational skills• Strong analytical and problem-solving skillsPreferred Skills • Experience with travel, medical, dental, and vision claims or working in a support role for the claims team • Cost containment/provider relations experience • Experience with medical coding standards • GHIP recovery/coordination of benefits/subrogation • Experience in handling US medical invoices/claims
Job Title
Claims Administrator