Claims Adjudicator (On-Site)

Job Description

This position is 100% on-site.

Hours : 8 : 30am - 4 : 30pm Monday to Friday.

We are seeking a Claims Adjudicator to join our BPA team in Halifax.

The Claims Adjudicator provides timely and accurate adjudication and reimbursement of benefit claims submitted by members covered under our clients’ Benefit Trust Funds.

He or she provides courteous and professional customer service while maintaining departmental standards.

The Claims Adjudicator will :

• Be responsible for analyzing and adjudicating claims according to contract provisions with the provider agreement up to $2,500.
• Maintain responsibility for evaluating all claims within the 5-day service standard of the Company
• Correspond and communicate via telephone, written correspondence or face-to-face with members, consultants, providers and other internal and external customers
• Apply guidelines, determine coverage, complete eligibility verification, and identify discrepancies
• Verify data entry for accuracy and completeness
• Meet monthly production benchmarks, daily and weekly

To be successful as aClaims Adjudicator with BPA, you will need :

• 1-2 years experience adjudicating medical / dental / vision claims or accident benefits claims
• Analytical skills to research, review and assess claims
• Strong verbal and written communication skills
• Exceptional customer service skills
• Strong attention to detail with exceptional organization skills
• Ability to manage multiple cases simultaneously
• Ability to learn complexities of multiple benefit plans
• Intermediate computer skills in the use of related computer applications, including Microsoft Word, Excel, Outlook, the administration system (MEBS) and the claims adjudication system (TELUS) in order to enter and track program data, process claims and, prepare reports and correspondence
• To be a team player with strong interpersonal skills
• To assists with coverage at reception as required
• To perform any other duties that may be assigned

What's in it for you :

• Learn by working alongside our experts
• Extended health care and dental benefits
• A retirement savings plan with company contributions
• A suite of Health & Wellness offerings
• Mental Health programs and support for you and your family
• Assistance for the completion of industry designations
• Competitive compensation

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 BPA :

BPA is a division of People Corporation and has served members and beneficiaries in their local communities since 1958. BPA is dedicated to providing a superior benefits experience to our members, businesses, and trusts in the local communities in which they live and operate.

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.