Claims Adjudicator- Open until filled

Government of Manitoba; Winnipeg; On-site; CAD 55,000 - 65,000; Full time

Job summary

A provincial government agency in Winnipeg seeks Claims Adjudicators to review medical claims and provide support in processing. Candidates should have post-secondary education in public administration or similar fields and experience interpreting healthcare policies. Excellent communication skills and the ability to work independently are essential. The position offers a competitive salary and comprehensive benefits package.

Benefits

Extended health care

Dental care

Vision care

Long term disability insurance

Defined pension plan

Qualifications

• Extensive work experience using and interpreting the Manitoba Physician’s Manual.
• Experience interpreting policies related to monetary payouts preferably in a healthcare setting.
• Experience using and interpreting healthcare-related regulations.

Responsibilities

• Review and verify accuracy of medical claims for insured services.
• Interact with service providers and billing agents to respond to inquiries.
• Provide information regarding claims submission process.

Skills

Strong verbal communication skills

Ability to make decisions and problem solve

Experience providing customer care

Ability to work independently

Knowledge of medical terminology

Education

Post secondary education in public administration, business, health, or administration

Tools

ICD-9 coding

Job description

Overview

CL4 Clerk 4 — Regular/full-time

Department: Health, Seniors and Long Term Care

Location: Winnipeg, MB

Salary: CL4 $55,472.00 - $64,777.00 per year

Closing Date: September 22, 2025

Note: Employment Equity is a factor in selection for this competition. Consideration will be given to Indigenous people and persons with disabilities. An eligibility list may be created for future term and regular opportunities, subject to staffing approval, and may remain in effect until exhausted.

About the role

The Department of Health, Seniors and Long-Term Care is seeking qualified Claims Adjudicators for the Claims Unit of the Insured Benefits Branch. This unit provides front-line service to fee-for-service providers through the adjudication of electronic claim submissions and responses to payment disputes/billing inquiries from practitioners. The position also provides front-line service to the public through information regarding benefits under the provincial health plan.

To be considered for this competition you must submit an application form and a resume.

Responsibilities

Using established rules and guidelines, Claims Adjudicators review and verify the accuracy of medical claims for insured services to ensure timely payment to medical practitioners. Claims are processed electronically using an electronic claims processing system and may require additional analysis and manual calculations to ensure accuracy. Adjudicators will interact with service providers, medical practitioners and/or their billing agents via phone, e-mail and written correspondence to provide responses to inquiries about claims. Adjudicators will also respond to general inquiries about the claim’s submission process.

Qualifications

Essential:

• Post secondary education in public administration, business, health, or administration. A combination of education, training and related experience may be considered.
• Extensive work experience using and interpreting the Manitoba Physician’s Manual.
• Experience interpreting and applying policies, procedures and/or regulations related to monetary payouts preferably in a healthcare setting.
• Experience providing customer care, support and assistance in a professional environment.
• Strong verbal communication skills to effectively communicate with various stakeholders.
• Ability to make decisions and problem solve.
• Ability to take initiative and work independently with minimal direction/supervision.
• Experience using ICD-9 coding (The International Classification of Diseases, Ninth Revision, Clinical Modification).
• Knowledge of medical terminology.

Conditions of Employment

• Must be legally entitled to work in Canada
• Must provide and maintain a satisfactory Criminal Record Check.

Benefits

The Manitoba Government offers a comprehensive benefit package including extended health care, health spending account, dental care, vision care, long term disability insurance, group life insurance, maternity/paternity leave, family-related leave, and a defined pension plan (with some portability between the Civil Service Superannuation Board and employers).

How to Apply

To apply, submit an application form and a resume. Complete the application form at the link below or contact Human Resource Services under “Apply to” to request a copy of the application form. The selection board will rely only on information provided in this form to determine whether a candidate will be invited for further assessment. Note: You are not required to submit a cover letter but may be asked to submit references or other documentation at a later point if invited for further consideration.

Apply to: Advertisement # 44116

Talent Acquisition

Human Resource Services

600-259 Portage Avenue, Winnipeg, MB, R3B 2A9

Phone: [phone]

Fax: [phone]

Email: [e-mail]

When applying to this position, please indicate the Advertisement Number and Position Title in the subject line and/or body of your email.

Applicants may request reasonable accommodation related to the materials or activities used throughout the selection process. Your cover letter, resumé and/or application must clearly indicate how you meet the qualifications.

We thank all who apply and advise that only those selected for further consideration will be contacted.