Medical Claims Clerk

Job Description

We are seeking a Medical Claims Clerk to join our Coughlin team in Ottawa.

The Claims Clerk is required to process group plan member health claims by applying established policies and procedures, respond to written, electronic, or in-person inquires related to claims, benefits payable, and general group plan policies, and perform other related administrative duties.

The Medical Claims Clerk will :

• Responding to clients, members, or other external contacts in a prompt, efficient, and courteous manner at all times.
• Preparing correspondence using company standard templates for members, carriers, or clients.
• Providing accurate and timely information / assistance to members and clients concerning coverage, processing and paying claims, and benefits parameters.
• Informing the manager of any issues which arise out of the course of daily work.
• Liaising with medical professionals
• Data entry related to claims and member correspondence.
• Verifying eligibility of members, drugs, services, providers, co-insurance, deductibles, payments, and procedure / dental codes, including reviewing previous submissions and group contracts / policies.
• Verifying cheques, letters, forms, addresses, and reports for accuracy and completion.
• Producing claims payments, including applying applicable deductibles.
• Interpreting policies and administrative practices and correctly applying them in the adjudication of claims.
• Electronic data and document maintenance to include scanning, faxing, filing, destroying, photocopying, data entry and any processes required to prepare documents for these actions.
• Verifying work and data in the scope of the position for accuracy and completion.
• Prioritizing work to ensure effective time management.
• Maintaining procedure manuals, including documenting new procedures and updating current

procedures

To be successful as a Medical Claims Clerk with Coughlin & Associates, you will need :

All-star candidates will have :

What's in it for you :

At People Corporation we are committed to helping businesses succeed. We are a national provider of benefits, retirement, wealth, wellness, and human resource solutions. Our experts and solutions serve over 20,000 clients representing nearly 3 million Canadians. We offer customized solutions designed to fit the unique needs of businesses and their employees, members and stakeholders.

About Coughlin & Associates Ltd. :

Across the country, thousands of Canadians rely on Coughlin & Associates Ltd. to design and administer their group medical, dental, disability, life insurance and pension benefits. Coughlin is a full-service benefits consultant and third party administrator. Our services include :

Established in 1958, Coughlin & Associates Ltd. provides services to some of Canada’s most respected companies, unions and public service organizations

Providing an inclusive, accessible environment, where all employees and clients feel valued, respected and supported is something we're committed to. We are dedicated to building a workforce that reflects the diversity of the communities in which we live, and to creating an environment where every employee has the opportunity to reach their potential.