Quality Assurance – Claims (Winnipeg, MB)
This is an exciting time to join People Corporation. Our high level of acquisition activity and our consistent organic growth continue to define and further enhance our benefits, pension, and HR products and services and how they are delivered to our clients.
We are in search of a dynamic Employee Benefits professional to join our Claims team as a Quality Assurance – Claims, reporting to the Director of Claims and Special Projects. The Quality Assurance – Claims, is responsible for monitoring claims and ensuring accuracy.
As the Quality Assurance – Claims you will be responsible for:
- Reviewing all plan and benefit coding on the claim adjudication platform as part of the conversion process.
- Validating member and dependent information loaded onto the claim adjudication platform.
- Reviewing and auditing claim adjudication and payments to ensure adherence to adjudication protocols and quality standards.
- Provide recommendations for training based upon audit results.
- Reviewing reports for anomalies, mapping tables and data validation.
- Initiate and/or implement corrective action as needed in order to ensure that an excellent standard of service and a high level of client satisfaction is maintained.
You and Your Experience:
- Minimum of three years’ of experience with adjudication of health and dental claims.
- A positive, can-do attitude and approach and who wants to be a “builder” working in a fast paced environment.
- Excellent communication skills, both written and verbal, to interact with internal and external clients. French bilingual would be considered an asset.
- Ability to multi-task, prioritize and work to deadlines to meet client and internal needs. Project management skills would be an asset.
- Excellent problem solving and troubleshooting skills.
- A high level of attention to detail is required.
- Client focused with an unwavering commitment for service excellence.