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Job Description
- Req#: 2431
- Review claims and validate claim coverage;
- Confirm clean bill components are present;
- Review all verbal and written communication within the file and review applicable policy wording;
- Review bills for rendered services, coding and reasonable customary charges;
- Ensure bills are directed to the appropriate internal financial process;
- Establish presence of claims requirements as per policy wording (i.e:proof of payment and authenticity of bills/claims);
- Research and confirm global claims influences (i.e. travel advisories);
- Request missing claim components as required for adjudication;
- Clarify and explain denials if required;
- Provide notice of claim decision via email, phone or formal letter.
- College diploma or equivalent
- 1-2 years of experience in a customer service-related position
- Strong communication skills, both verbal and written
- Ability to handle sensitive and confidential information
- Ability to assess situations, respond appropriately and make independent decisions
- Benefits or claims examination experience is an asset
- Bilingualism in French is an asset
- Regular business hours; 8:30am-5:00pm
- Global Excel offers more than a position;
- We offer a professional future with a competitive compensation including base salary, performance bonus and benefits;
- Please reach out to your local HR department if you would like to know more about benefits offered in your site.
- Competitive wages;
- Bilingual language premium when applicable;
- Group health /dental benefits, RRSP matching;
- Paid training and the opportunity for professional development;
- Growth and advancement opportunities;
- Work life balance;
- Focus on health and wellness initiatives with an excellent EAP program;
- Employee engagement programs that focus on fitness, food and fun.
Job Description
Are you a person who is detailed oriented has excellent organizational skills? Are you interested in working in a multilingual, dynamic and friendly environment that encourages personal and professional development? We would love to meet you!
As a Claims Assessor - Medical in the Claims Management team, you’ll be responsible for evaluating and enforcing claim benefits and limitations. Your role is to be an advocate for both the company and the client.
What does your typical day look like?
What skills and experience are we looking for?
What does Global Excel offer you?
Note: Only applicants selected for an interview will be contacted.
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
To get a taste of the Global Excel life and for more information on our company, visit our Facebook page and website:
About the company
Global Excel is a worldwide premium medical cost containment company, providing services to a broad range of market segments. Our partners trust our expertise in controlling healthcare costs for the management of their claims dollars as well as our abi...
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