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Claims Administrator

Claims Administrator

AppleOne Employment ServicesOntario, Canada
2 days ago
Salary
CA$20.00–CA$23.00 hourly
Job type
  • Full-time
Job description

Bilingual Claims Administrator

Remote role office located in Toronto

20-23ph

Overview :

The Claims Administrator provides administrative support to the Claims Team, handling phone calls, emails, and claims processing tasks. This role requires strong time management and communication skills. Bilingual proficiency in English / French is preferred.

Key Responsibilities :

  • Manage inbound / outbound phone calls and document communications in the claims system.
  • Respond to emails, triage claims mail, and direct to appropriate folders or examiners.
  • Escalate complaints, appeals, and legal correspondence as needed.
  • Process denied EOBs, accounts receivable inquiries, and EFT information for paid claims.
  • Retrieve and manage claims documents from provider sFTP sites.
  • Maintain compliance with PIPEDA and HIPAA regulations.
  • Enter invoices and open claims in the claims system.
  • Provide excellent customer service and collaborate with teams daily.

Qualifications :

  • High school diploma or equivalent.
  • 2+ years of administrative experience, preferably in the travel insurance industry.
  • Previous claims experience is a real asset
  • Proficiency in MS Word and Excel.
  • Strong communication, organizational, and problem-solving skills.
  • Bilingual in French and English is preferred.
  • Preferred Skills :

  • Experience with travel, medical, dental, and vision claims.
  • Knowledge of medical coding, cost containment, GHIP recovery, and US medical claims.
  • This is currently for an active job opportunity .

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