Bilingual Clinical Applications Specialist supporting GE HealthCare perioperative technologies. Delivering clinical training, product demonstrations, and customer implementation support across Canada.
About the role
- Claims Care Representative responsible for conducting the initial claim review for assigned business lines. Engaging with claimants and stakeholders effectively to ensure claims are processed efficiently.
Responsibilities
- Effectively manages case/claims assignments and responds to inquiries from claimants regarding claim status and/or requests for claim forms.
- Manages the initial stages of screening claims.
- Applies an excellent understanding of certificate and policy provisions.
- Sets-up claims, including verifying policyholder information, policy effective date, premium status, and verification of claim eligibility and including ensuring appropriate claim forms are delivered to claimant.
- Communicates with key stakeholders including claimant, business partners, plan sponsors, physician, employers, verbally and/or in writing. Handles a variety of inquiries varying in complexity.
- Ensures compliance with Quality Assurance requirements and procedures
- Maintains compliance all KPI’s, standards, controls, policies, and practices as an active participant in the Company’s Information Privacy and Security Program.
- Perform other duties as assigned.
Requirements
- Post-Secondary Education preferred or equivalent work experience.
- This role requires strong French and English communication skills because it involves regular, direct interaction with French- and English-speaking customers and colleagues.
- Ability to perform tasks simultaneously within deadlines.
- Strong attention to detail.
- Fundamental knowledge of computers and keyboarding skills.
- Strong communication skills (strong telephone and interpersonal skills).
- Ability to make decisions with resource guidance
- Strong commitment to quality of work
- Exceptional customer service.
- Knowledge of insurance practices and principles are assets.
- Knowledge of medical terminology, policy provisions, and provincial regulations are assets.
- FLHC, FLMI or ALHC designation are an asset.
Benefits
- Flexible work arrangements with monthly financial allocations to support your work-life balance;
- Generous starting paid vacation time, plus additional vacation days for every year of service;
- Paid volunteer day so you can dedicate time to a cause you are passionate about;
- Paid personal and wellness days to support your total wellbeing;
- Educational assistance of up to $3,500 a year (with approval from your manager);
- Flexible health and wellness account (in addition to comprehensive drug and dental coverage) to help pay for a wide range of wellbeing services that are meaningful to you;
- Up to 14% of combined contributions to the RRSP matching program;
- Family-friendly maternity/parental leave and,
- Many more benefits, perks and programs.
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