Junior Claims Adjudicator (In-Office)

We are seeking a Jr. Claims Adjudicator to join our BPA team in Mississauga.

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.

The Jr. Claims Adjudicator will:

• 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
• Provide Claims Team Lead with dental claims that need further review by dental consultant
• Evaluate all claims within the 5-day service standard of the company
• Verify data entry for accuracy and completeness
• Maintain security and confidentiality of client records
• Perform data entry of claims sent to dental consultant is added and confirmed on a spreadsheet
• Be responsible for other duties as may be assigned from time to time by Management
• Analyze and adjudicate paper or electronically submitted claims, according to contract provisions and maintaining a claims assessment quota of 140 claims per day, depending on the claim complexity

To be successful as Jr. Claims Adjudicator with BPA, you will need:

• Strong verbal and written communication skills
• Strong attention to detail with exceptional organization skills
• Ability to manage multiple cases simultaneously
• Analytical skills to research review and assess claims
• Exceptional customer service skills
• Familiarity with contract wording, policy provisions and the Insurance Act
• Compliant with government regulation pertaining to the Privacy Act (PPEIDA)
• Intermediate computer skills 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

All-star candidates will have:

• Some experience working in the medical claims field

What's in it for you:

• A retirement savings plan with company contributions
• Extended health care and dental benefits
• A suite of Health & Wellness offerings
• Assistance for the completion of industry designations
• Competitive compensation
• Mental Health programs and support for you and your family
• Learn by working alongside our experts

At People Corporation we are committed to helping businesses succeed. We are a national provider of benefits, retirement, wealth, wellness, and human resource solutions. Our experts and solutions serve over 20,000 clients representing nearly 3 million Canadians. We offer customized solutions designed to fit the unique needs of businesses and their employees, members and stakeholders.

About BPA:

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 [email protected]