Health and Dental Claims Examiner

QUALIFICATIONS

• Post Secondary diploma or recognized business experience in a related field
• A minimum of two year’s experience adjudicating health and dental claims
• Knowledge of and hands-on experience using Windows and Microsoft Office technology
• Excellent keyboarding skills.
• Superior customer service skills including an excellent telephone manner.
• Ability to work quickly and accurately under pressure
• Must be able to meet departmental standards for claims processing, after a pre-determined training period.
• Knowledge of and aptitude for calculating benefit payments.
• Possess organizational skills, oral and written
• English/French Bilingual is an asset though not a requirement

DUTIES AND RESPONSIBILITIES

Some of the duties of this position include the following:

• Processes Extended Health & Dental benefits through the use of an automated claims payment system.
• Ensures all claims are processed in date order, by automatically assisting other examiners in the processing of their assigned plan(s) when their own client base is in good order.
• Maintains daily production requirements to a minimum as determined by the Team Leader.
• Liaises in a professional manner with insurance agencies, doctors, trustees, members, management, lawyers, etc., ensuring that only allowable information is released to recognized recipients and that all information is released in writing.
• Keeps abreast of industry and government requirements.
• Operates automated claims payment system and performs manual calculations as required.