The Junior Health and Dental Claims Adjudicator is accountable for processing health and dental claims according to standards, policies and procedures.
iA Financial Group is the fourth largest life and health insurance company in Canada and offers a wide range of products for all stages of life and to meet the needs of clients across its vast sales network. Founded in 1892, iA Financial Group’s stability and solidity make it an employer of choice that invests in its employees and their development over the long term.
With operations across Canada and in the United States, iA Financial Group and its over 5,000 employees work hard every day to offer the best service to over four million clients.
We are pro-actively looking for Health and Dental Claim Adjudicators to add to our Toronto team for future/upcoming opportunities.
Reporting to the Manager, Group Health and Dental Claims, the Junior Health and Dental Claims Adjudicator is accountable for processing health and dental claims according to standards, policies and procedures.
The Main Responsibilities will include:
- Analyzing and processing health and dental claims, which will involve collecting the required information, determining the reasonable cost according to diagnosis and accepting or declining the claim according to the terms of the contract.
- Validating claims, documents and providers and makes the appropriate decision (R&C, maximum, references) based on his level of authority. Objective is to become knowledgeable and expert in ability to process all types of claims with autonomy while maintaining a good level of production and quality.
- Communicating with members and providers to obtain required information to process claims and attain an immediate solution to reduce processing delays
- In addition to the above, may be requested upon occasion to perform other tasks to contribute to accomplishing the team’s objectives.
- College diploma or equivalent experience
- Ability for data entry
- Analytical skills
- Positive attitude and professionalism
- Ability to work independently
- Customer service skills
- Ability to handle pressure
- Willingness to learn
- Team player and integrity
- Bilingualism is an asset
- Commitment to respect confidentiality
- Ability to work overtime during peak seasons