Bilingual Claims Administrator

MSH Americas - Diot-Siaci Group; Toronto; Hybrid; CAD 42,000 - 66,000; Full time

Benefits offered by this job

Hybrid work

Employee assistance program

Wellness account

RRSP matching

Sick days

Job summary

MSH Americas - Diot-Siaci Group is seeking an experienced Claims Administrator to provide administrative support on claims, handle calls, and respond to emails from providers and plan members. You will assist the claims processors in adjudicating claims when necessary, and ensure compliance with privacy and health regulations.

The role requires strong time management, travel insurance claims experience, and proficiency in MS Office.

Qualifications

• High school diploma or equivalent.
• Experience in the travel insurance industry is required.
• Minimum 2-3 years of 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 skills.

Responsibilities

• Provide excellent customer service for claims matters both in person and via written correspondence.
• Handle both inbound and outbound calls to members and health providers as required.
• Work closely with the Claims team and other teams on a day-to-day basis.
• Ensure all work complies with the PIPEDA and HIPAA.
• Answer emails and respond accurately to claims inquiries ensuring customer satisfaction.
• Accurately document all communication with members and providers in magenta.
• Triaging all incoming claims mail and validating coverage.
• Entering all claims in magenta upon receipt of the mail.
• Generating payments on approved/denied claims; sending payments to Accounting and emailing/mailing denials to members/providers.
• Filing claims and purging files when required.
• Processing and packaging Morcare claims for iA.
• Reviewing /closing pending claims.

Skills

MS Office

Excel

Verbal communication

Written communication

Time management

Organizational skills

Problem solving

Claims processing

Policy interpretation

Teamwork

Education

High school diploma

Tools

Magenta

Job description

You are an experienced administrative professional who can multitask and meet tight deadlines. You thrive in a fast-paced, team environment and will provide excellent customer service via email, fax, and phone. You will have the desire to develop an in-depth understanding of this position and be able to easily maneuver through numerous policies to assess claims and inquiries accurately. You are a powerful team player.

The Claims Administrator will be responsible for providing administrative support on claims. This role involves handling inbound and outbound phone calls, as well as answering a variety of emails from providers and plan members. The Claims Administrator assists the claims processors in adjudicating claims when necessary. This role requires strong time management skills, claims experience, and policy interpretation.

In this role, you’ll get to experience:

• Provide excellent customer service for claims matters both in person and via written correspondence


• Handle both inbound and outbound calls to members and health providers as required


• Work closely with the Claims team and other teams as required on a day-to-day basis


• Ensure all work complies with the PIPEDA and HIPAA


• Answering emails and responding accurately to claims inquiries ensuring customer satisfaction


• Accurately document all communication with members and providers in magenta


• Triaging all incoming claims mail and validating coverage


• Entering all claims in magenta upon receipt of the mail


• Generating payments on approved/denied claims; sending payments to the Accounting department and emailing/mailing denials to members/providers


• Filing claims and purging files when required


• Processing and packaging Morcare claims for iA


• Reviewing /closing pending claims

What you bring:

• High school diploma or equivalent


• Experience in the travel insurance industry is required


• Minimum 2-3 years of 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 skills

What do you need to succeed?

• Experience in processing health, dental, and vision claims or working in a support role for a claims team


• Experience with medical coding standards


• GHIP recovery/coordination of benefits/subrogation


• Experience in handling US medical invoices/claims

What’s in it for you:

• Hybrid work environment


• Employee assistance program


• Wellness account


• RRSP matching


• Generous amount of sick and flex days


• Opportunities to learn new skills, grow, and move into different roles


• A work environment that embraces diversity and promotes inclusivity.


• Supportive leadership prioritizes your success and cares about your well-being.


• A growth trajectory designed to expand vertically and horizontally, providing opportunities to pursue your passions and acquire new skills.