Claims Analyst

Position Type:
Permanent

If you're looking for a fulfilling career that can make a real difference in your life, and the lives of others, you've come to the right place.

As a national health solutions partner, we put people first in everything we do - and that begins with our team of 8,000+ professionals who bring a cross-section of diverse life experiences and career expertise to Medavie. By collaborating and innovating together, our employees are creating industry-leading solutions in insurance, primary care and emergency medical services that impact millions of lives in Canada each year.

Our mission is to improve the wellbeing of Canadians so that every life can be lived to the fullest - and it's reflected in our award-winning culture. We celebrate individuality and value the diverse perspectives and skills our employees contribute. We go beyond providing competitive pay and comprehensive benefits to offer opportunities for personal and professional growth, flexible work options, meaningful experiences, and supportive leadership. Medavie is where employees can be their best selves, feel they belong, and achieve their full potential. Be part of it by applying for a position with us today.

POSITION SUMMARY:

Under the Team Leader's supervision, you are responsible for processing claims relative to your decisional level in accordance with the policies and procedures for claims payment. To help you perform your duties, you use a computer system to obtain and/or transmit information.

DETAILED RESPONSIBILITIES:

• Analyze health/dental insurance claims to determine if the expenses submitted are eligible for the insurance benefit and deny the claim, if applicable;
• Obtain any prior information required for claim payment. Communicate in writing or by phone as needed;
• Enter the data in the computerized claims processing system;
• Interact with the computer system by responding to system requests to accept or deny payment of a claim with respect to the group coverage and/or insured's eligibility. In order to perform this interaction, data queries are required as well as the application of claims payment policies and procedures;
• Create self-billed insureds in the computer file;
• Perform all calculations required to pay a claim when the computer system cannot calculate them automatically;
• Perform any other similar or general tasks as required by the position or as requested by the supervisor.

REQUIRED QUALIFICATIONS:

• College diploma (D.C.S.) or equivalent
• Fluent in spoken and written French and good knowledge of written English
• Good knowledge of health/dental insurance ( an asset)
• LOMA courses 1 and 2 completed as per company policy (an asset)

REQUIRED SKILLS:

• Analytical skills
• Sense of initiative and autonomy
• Organizational skills
• Customer focus

We believe our employees should reflect the communities we serve and welcome applications from candidates of all backgrounds. To provide the best experience possible, we will support you with accommodations or adjustments at any stage of the recruitment process. Simply inform our Recruitment team of your needs. We are committed to making sure recruitment, retention, advancement, and compensation are fair and accessible while following all relevant human rights and privacy laws . We appreciate everyone who has shown interest in this position. Only those selected for an interview will be contacted.

If you experience any technical issues throughout the application process, please email: [email protected] .