We are seeking a term Junior Claims Adjudicator (Term) to join our BPA team in Vaughan. This is a 12-month fixed term. The Junior Claims Adjudicator provides timely and accurate adjudication and reimbursement of benefit claims submitted by members covered under the L.I.U.N.A. Local 183 Member’s Benefit Trust Fund. He or she provides courteous and professional customer service while maintaining departmental standards. This position is 100% in-office. Working Hours: Monday to Friday 8:30 am – 4:30 pm Special working condition: rotating shift schedule for Wednesday 1pm to 8pm and Saturday 7am to 12:30pm. Over time, may be required should the claims turnaround exceed the 5 day Company Standard. The Junior Claims Adjudicator (Term) will: Responsible 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. ? Provide Claims Team Lead with dental claims that need further review to dental consultant. ? Data entry of claims sent to dental consultant is added and confirmed on a spreadsheet. ? Maintain security and confidentiality of client records. ? Other duties as may be assigned from time to time by Management. Key Contacts/Relationships External and Internal: Reports to Claims Supervisor, Team Lead and Operations Manager. ? Receives work direction from Claims Supervisor and Claims Team Lead. ? Deals directly with Benefit Plan participants/members, their dependents and beneficiaries by phone, fax, email, mail or in person. ? Corresponds with insurance providers, consultants and Union Representatives with regards to specific claims submitted. ? Work cooperatively as a member of the L.I.U.N.A. Local 183 Trust administration team to provide superior customer service. To be successful as a Junior Claims Adjudicator (Term) with BPA, you will need: Fluency in English as well as at least one of Portuguese, Spanish or Italian preferred. Analytical skills to research review and assess claims. Familiarity with contract wording, policy provisions and the Insurance Act. Compliant with government regulation pertaining to the Privacy Act (PPEIDA). Strong verbal and written communication skills. Strong attention to detail with exceptional organization skills. Ability to manage multiple cases simultaneously. Intermediate computer skills in the use of related computer applications including Microsoft Word, Excel, Outlook, AS400, CRM, Telus and Adjudicare in order to enter and track program data, process claims and, prepare reports and correspondence. Participation in company sponsored insurance programs such as FLMI, ACS, ALHC, C.E.B.S. and successful completion of these courses of study during tenure in the position. Cooperative team player with strong interpersonal skills. Exceptional customer service skills. All-star candidates will have: Previous experience in the group benefits industry What's in it for you: Learn by working alongside our experts Competitive compensation 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. If you require an accommodation or an alternative format of any posting please reach out to careers@peoplecorporation.com. We know that it's the vast expertise and commitment of our teams in People Corporation and our Partner Firms that have put us where we are today. We value our employees and provide competitive salaries, a comprehensive group benefits plan, and a generous retirement savings plan. And we're in it for the long haul - once you join us, we want you to thrive. If you want to make a difference in the lives of customers, if you take pride in a job well done, and if you like to have fun, talk to us. To learn more about our Partner Firms, please click on the link below. https://www.peoplecorporation.com/en-ca/about-us/our-partner-firms Submit your information for future opportunities. 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. If you require an accommodation or an alternative format of any posting please reach out to careers@peoplecorporation.com. For more information on Accessibility at People Corporation, visit our link https://www.peoplecorporation.com/en-ca/accessibility-statement.
