My Insurance Recruiter Inc
Location
Thornhill, ON | Canada
Job description
Our Client is dedicated to International Corporations, Institutions and Global Organizations, Insurers and Health Carriers. They provide worldwide Remote Medical & Security Services, Business Travel Risk Management and International TPA & Cost Containment Services.
1. ACCOUNTABILITY OBJECTIVE
· Accountable for providing care and oversight to insured members in compliance with their policy, ensuring excellent quality of care and cost containment for non-emergent or out-patient cases.
2. SCOPE
· Works professionally and effectively with all employees at the Company, in a high volume, fast-paced environment.
· Communicates professionally and regularly with internal and external clients (patients, clients and health care providers).
3. RESPONSIBILITIES
• Manages less serious cases from inception through completion of treatment.
• Maintains comprehensive and accurate case notes, cost estimates and other relevant data.
• Presents cost effective options for treatment to both the client and the insured.
• Maintains all records related to case management activity, financial processes, strategic plans and activities as it relates to the day to day operations.
• Evaluates insured eligibility status and benefits, while providing pre-certification authorization as required.
• Works closely with the Medical Team to ensure appropriate medical management on all cases.
• Assesses suitability of length of stay, tests, and diagnostics as per published standards and as determined by our clinical team.
• Operates as the liaison between the patient/family members, the client and the provider(s).
• Utilizes problem solving skills and negotiating techniques to resolve conflict issues.
• Ensures timely and efficient case management processes by assisting Case Managers with clerical/support activities related to their assigned cases.
• Screens and completes non-medical requests such as benefit clarifications, extended length of stay information, updates on procedures, etc.
• Identifies cases ready for closure and completes applicable procedures.
• Obtains “case cost to date” information from providers and documents in system.
4. YOUR KNOWLEDGE & EXPERIENCE
· 2 years of office or customer service experience preferably in a medical or insurance environment.
· Post secondary education or related equivalent experience.
· Medical Terminology training.
· Excellent working knowledge of computer programs.
· Superior verbal and written communication skills.
· Excellent communication in English and multiple languages
5. EFFORT & WORKING CONDITIONS
· Discretion in dealing with confidential/sensitive information.
· Ability to work 40 hours a week rotating 7 days Monday to Sunday with Statutory holiday coverage as scheduled.
· Coordination and prioritization of time sensitive tasks.
· Critical and analytical thinking required.
· Sits at a desk to perform the duties of the job up, as well as walks and stands within the office.
· Modifies behaviour and/or actions to easily adjust to new situations in a positive manner. Encourages others to adjust to changes.
· Concentrated attention for prolonged periods of time.
· Excessive use of telephone, computer and other office equipment in high volume call centre.
· Exposure to constant interruptions/distractions, deadlines and multiple demands.
Other
• Adheres to all policies and procedures as outlined in the Employee Handbook and client specific protocols.
• Performs all work in a PIPEDA and HIPAA compliant manner.
• Works in compliance with the Occupational Health and Safety Act and related legislation.
• Ensures strict standards for claimant/client confidentiality and complies with organizational and governmental regulations/policies.
• Other related duties as assigned.
In return for your unique skill set, the following is offered in addition to a base salary:
• Extended health and dental benefits
• An RRSP matching program
• Bonus incentive • Free parking• A chance to make a difference
If you are interested in applying, please contact (email or text) to: Rachel HoevenaarsJob tags
Salary
