Claims Analyst

• Receiving and assessing claims through a scanned image/paperless environment;
• Processing health and dental claims
• Ensuring all details have been provided to accurately process and approve claims;
• Asking questions to determine and clarify details on claim submissions; and
• Organizing work and information to ensure claims are paid accurately and efficiently.
• Provide excellent customer service when calling providers or members.

• Education: Post-secondary education in a related field.
• Work Experience: Minimum six months work experience in an office and customer service environment.
• Other Qualifications: Experience with data entry, knowledge of claims processing, eligibility and claims systems, and medical terminology is considered an asset.
• Computer Skills: Experience working with Microsoft Office Suite and Lotus Notes.
• Language Skills: Bilingualism in English and French is considered an asset.

• Knowledge: Has the functional and technical knowledge and skills to do the job at a high level of accomplishment.
• Analytical Thinking: Makes decisions in a timely manner, sometimes with incomplete information and under tight deadlines and pressure and is able to make a quick decision.
• Communication Skills: Practises attentive and active listening and has the patience to hear people out and can accurately restate the opinions of others even when he/she disagrees.
• Customer Orientation: Is dedicated to meeting the expectations and requirements of internal and external customers. Gets first-hand customer information and uses it for improvements in products and services. Acts with customers in mind and establishes and maintains effective relationships with customers and gains their trust and respect.
• Execution and Organizational Skills: Enjoys working hard; is action oriented and full of energy for the things he/ she sees as challenging. Is not fearful of acting with minimum planning and seizes opportunities more than others.
• Team Work Skills: Can quickly find common ground and solve problems for the good of all; can represent his/her own interests and yet be fair to other groups. Can solve problems with peers with a minimum of noise and is seen as a team player and is cooperative. Easily gains trust and support of peers; encourages collaboration and can be candid with peers.

Job Segment: Data Entry, Claims, Equity, Administrative, Insurance, Finance