Claims Administrator Jobs

KIT Recruitment is pleased to work with this international, global leading distributor of quality, revolutionary, health care products in search of a English/French (bilingual) Claims Administrator located in Mississauga and conveniently on the bus route too!

As a Bilingual Claims Administrator, you will provide support to the program of the company by pursuing authorization and payment for medical devices. You will support clinic reimbursement services, client relations via prompt and effective benefits verifications and secure authorizations.

Bilingual Claims Administrator details:

• · Three weeks vacation
• · 5% bonus plan
• · RRSP match up to 4%
• · $60,000- $65,000K
• · Benefits from day one!
• · Hybrid*
• · Employee Profit Sharing

Qualifications

Looking for someone with a passion for patient advocacy with 4-5 years of reimbursement experience. **processing insurance claims. SAP a must, as well as fluent in French and English.

• · Bachelor’s degree in a business-related field
• · Must display professional and friendly persistence, manage detailed information, maintain high level of organization, and display strong proficiency in multi-tasking by effectively managing time, projects, and priorities.
• · Proficient knowledge of SAP is a MUST
• · Minimum 2 years experience working in Customer Care/Reimbursement environment
• · Intermediate MS Office Suite knowledge, especially Excel & PowerPoint
• · Native English/French language is a MUST, non-French speakers will not be considered
• · Medical authorisations experience an asset
• · Experience with Quebec Market is an asset
• · Strong persuasion/negotiation skills.

What you’ll be doing

• · Prepare & send predetermination letters to insurers & schedule appropriate follow-ups based on payer timeline and patient context using SAP workbench
• · Support all calls from sales team regarding orders/patient cases, enable sales force effectiveness.
• · Pre-screen all prescriptions for completeness and enters in SAP within 1 business day
• · Manage daily calls to payers to obtain authorization of reimbursement for the company’s product.
• · Process product sample requests per established program procedures
• · Perform benefits verification calls and provide coverage details letter to clinics within 24h of receipt of prescription
• · Input all sales orders (email, fax and web) on day of receipt
• · Process and expedite patient orders and confirm correct customer billing; includes contacting the appropriate departments to ensure the smooth processing and shipment of orders, ensuring all relevant documentation is attached to order / file as needed.
• · Communicate with patients to troubleshoot issues (product, shipping, pricing) and provide prompt resolution
• · Coordinate product complaints by collecting and documenting data from the patient to determine the issue and escalate as appropriate.
• · Clearly communicate coverage details and financing options to facilitate patient access to care
• · Investigate up-front denials through verbal & written communication with insurance companies.