New Job Claims Assessor - International Operations In Quebec

Claims Assessor - International Operations
Claims Assessor - International Operations

Claims Assessor - International Operations

Company : Global Excel Management
Salary : Details not provided
Location : Quebec

Full Description

Job Description:
Are you a people person with a knack for providing excellent customer service? Are you interested in working in a multilingual and friendly environment that encourages personal and professional development? We would love to meet you!

As a Claims Assessor, you’ll be evaluating and enforcing claim benefits and limitations based on a comprehensive understanding of the applicable policy wording. The claims assessor is responsible for qualifying a claim/bill for payment. Claims are reviewed for customer service and may require direct client contact. The assessors are responsible to contribute to cost containment efforts by validating bills for
services rendered, authenticity and reasonable and customary charges.

What does your typical day look like?

  • Review applicable policy wording and validate claim coverage;
  • Review all verbal and written communication within the file;
  • Review bills for rendered services, coding, and reasonable & customary charges;
  • Review medical information submitted for necessity of further requirements or internal specialist review;
  • Establish presence of claim requirements as per policy wording (i.e.: proof of payment and authenticity of bills/claims);
  • Request missing claim components as required for adjudication;
  • Ensure creation of appropriate follow up workflows;
  • Provide notice of claim decision and explanation including denials via phone, formal letter, or email;
  • Confirm and adjust (if required) claim entries.
What skills and training do you need?
  • College diploma preferred, but not required;
  • Experience in insurance product benefits and limitations an advantage;
  • Comprehension of healthcare system and billing practices an advantage;
  • Proficiency in Microsoft Office suite;
  • Excellent verbal and written communication skills in English, bilingualism is an asset (French most preferred);
  • Excellent organizational skills with a strong attention to detail and strong decision-making skills;
  • Ability to adapt to on-going change and work volumes in a fast-paced, customer focused environment.
We offer you:
  • Three weeks of vacation;
  • An extensive benefit package that includes health (100%), dental, life and travel insurance, as well as a retirement savings plan;
  • A flexible and supportive work environment offering several benefits such as a private medical clinic, on-call doctors, an on-site Bistro, and much more;
  • A company wellness program that includes an on-site gym, opportunities to participate in fitness classes, discounts at local businesses as well as “lunch-and-learns” on various topics linked to health and wellness;
  • Many opportunities for advancement, development and financial assistance to employees who wish to continue their education.
To get a taste of the Global Excel life and for more information on our company, please visit our Facebook and Instagram pages, as well as our website, and also our LinkedIn profile: