Senior Claims Adjudicator — Lead & Mentor

505 Coughlin Winnipeg; Winnipeg; Sur place; CAD 50 000 - 53 000; Plein temps

Résumé du poste

Coughlin & Associates Ltd. seeks a Senior Claims Assessor to join our team in Winnipeg, MB or Ottawa, ON.

You will adjudicate and process member claims, advise on benefits, respond to inquiries, and provide mentorship to Claims staff, serving as back-up to senior roles in the department. You will apply policies to adjudicate claims, prepare reports, verify eligibility and codes, and communicate clearly with members, carriers, and clients.

Qualifications

• Post-secondary education completed.
• Minimum 3+ years in health and dental claims adjudication or benefits administration.
• Strong knowledge of medical and dental terminology.
• Leadership abilities and team mentorship.

Responsabilités

• Adjudicate and process member health and dental claims per policies.
• Respond to inquiries regarding claims and benefits.
• Mentor and guide Claims Assessors; provide performance feedback.
• Verify eligibility, codes, deductibles, and payments; prepare ad hoc reports.
• Investigate discrepancies, overpayments, and complaints; take corrective actions.

Connaissances

Leadership

Communication

Attention to detail

MS Office

Formation

Post-secondary education in related field

Experience in health/dental claims adjudication

Outils

Microsoft Office Suite

Description du poste

Coughlin & Associates Ltd. seeks a Senior Claims Assessor to join our team in Winnipeg, MB or Ottawa, ON.

You will adjudicate and process member claims, advise on benefits, respond to inquiries, and provide mentorship to Claims staff, serving as back-up to senior roles in the department. You will apply policies to adjudicate claims, prepare reports, verify eligibility and codes, and communicate clearly with members, carriers, and clients.